目的:探讨宫清颗粒对人早孕绒毛、蜕膜组织细胞凋亡及信号转导的影响,为临床防治药物流产后异常子宫出血(简称药流后出血)提供生物学依据。方法:将120例受试者随机分为宫清药流组、茜芷药流组、单纯药流组及负压吸宫组,各30例,收集各组绒毛及蜕膜组织,观察细胞超微结构变化;TUNEL法检测细胞凋亡率(AR)、荧光分光光度计检测细胞内钙离子浓度([Ca2+]i)、免疫组化法检测蛋白激酶C(PKC)蛋白表达。结果:宫清药流组绒毛、蜕膜组织细胞超微结构出现典型凋亡改变,AR、[Ca2+]i升高,PKC蛋白表达降低,与其它3组比较差异有统计学意义(P〈0.05或P〈0.01)。结论:宫清颗粒能影响细胞内Ca2+及PKC介导的细胞信号转导,诱导人早孕绒毛、蜕膜组织细胞凋亡,促进绒毛与蜕膜组织完全排出,进而防治药物流产后出血。
Objective: To investigate the influence of Gongqing Granum on apoptosis and signal transduction of villi and decidua in human early pregnancy, and provide biological evidences for the treatment of abnormal uterine bleeding after medical abortion. Methods: 120 subjects were randomly divided into 4 groups: the medical abortion group with Gongqing, medical abortion group with Qianzhi, simple medical abortion group and induced abortion group, respectively, with 30 cases in each group. Villi and decidua tissues were collected from the 4 groups. The changes of cellular ultrastructure were observed, the apoptosis rate (AR) was detected using TUNEL method, the concentration of intracellular calcium ( [ Ca^2+] i) was examined by fluorospectrophotometer, and the expression of protein kinase C (PKC) was determined using immunohistochemistry. Results: Typical changes of apoptosis were present in villi and decidua tissues in the medieal abortion group using Gongqing. Compared with the other 3 groups, AR and [Ca^2+ ] i were obviously higher, while the PKC expression was lower, with statistical significance (P 〈 0.01 or P 〈 0.05 ). Conclusion: Gongqing Granum can prevent and treat abnormal uterus bleeding after drug abortion, for its impacts on the signal transduction mediated by Ca^2+ and PKC, which can induce apoptosis of villi and deeidua tissues, and then promote the complete elimination of villi and deeidua tissues.