乙型肝炎病毒感染孕妇胎盘绒毛病理形态研究

首都医科大学学报 ›› 2004, Vol. 25 ›› Issue (4): 441-445.

乙型肝炎病毒感染孕妇胎盘绒毛病理形态研究

李海燕¹, 陈瑞芬¹, 王小平¹, 周光德¹, 杨虹², 赵艳², 崔丹², 李珊², 韩超²

1. 首都医科大学病理解剖教研室;
2.首都医科大学附属北京佑安医院妇产科

收稿日期:2003-08-29 出版日期:2004-10-15 发布日期:2004-10-15

Morphologic Change of Villus and Analysis of Fetal Distress in Pregnancy with Hepatitis B Virus Infection

Li Haiyan¹, Chen Ruifen¹, Wang Xiaoping¹, Zhou Guangde¹, Yang Hong2, Zhao Yan², Cui Dan², Li Shan², H an Chao²

1. Department of Pathology, Capital University of Medical Sciences;
2. Beijing Youan Hospital, Affiliate of Capital University of Medical Sciences

Received:2003-08-29 Online:2004-10-15 Published:2004-10-15

摘要/Abstract

摘要：

通过分析妊娠合并乙型肝炎病毒(HBV)感染孕妇的胎盘绒毛及血管的病理变化, 探讨其与胎儿预后的关系。1)对20 例妊娠期HBV 表面抗原(HBsAg)、HBVe 抗原(HBeAg)、HBV 核心抗体(HBcAb)和HBV DNA 均阳性、肝功能正常的孕妇及其新生儿(研究组), 18 例无肝炎病毒感染、肝功能正常的孕妇及新生儿(对照组), 取胎盘进行病理检查, 并利用图像分析仪对胎盘绒毛横截面总面积和总周长, 单个绒毛的横截面面积、周长和等圆直径, 单个绒毛内血管数目及血管占绒毛的面积比值进行形态定量分析。2)计算2 组胎儿宫内窘迫的发生率。发现:1)研究组胎盘绒毛横截面总面积与对照组相比, 无显著差异, 绒毛总周长明显小于对照组(P<0.05)。2)研究组胎盘单个绒毛横截面面积、周长和等圆直径均明显大于对照组(P<0.05)。3)研究组胎盘单个绒毛内血管数目明显多于对照组(P< 0.05), 血管占绒毛的面积比值明显小于对照组(P<0.05)。4)研究组胎儿宫内窘迫发生率为55.0%, 对照组为11.1%。结果提示:娠合并HBV 感染, 可引起胎盘绒毛膜血管病, 这可能是胎儿发生宫内窘迫的主要原因。

关键词: 乙型肝炎, 胎盘, 绒毛膜血管病, 儿窘迫

Abstract:

The aim was to investigate the prognosis of fetal distress in pregnant women with hepatitis B virus(HBV) infection through analyzing the morphologic change of villus and blood vessel. ① Twenty pregnant women and their newborns were selected. The HBV surface antigen(HBsAg), e antigen(HBeAg), core antibody(HBcAb) and deoxyribonucleic acid(HBV DNA) were positive and the hepatic function normal. Eighteen pregnant women without HBV infection, normal hepatic function and their newborns were collected as control. Morphologic change of villus and blood vessel were observed.The total transverse areas and circumference of villus; the transverse area, circumference, diameter of single villus; the number of vessel in single villus and the area odds of vessel and villus were analyzed through image analysis machine. ② The incidence ratio of fetal distress in uterus was calculated. The results were: ① Comparing the investigate and the control, the total transverse areas was of insignificant difference. The total circumference was smaller than the control(P0.05). ②The transverse area, circumference and diameter of single villus of the investigate was larger than the control(P0.05). ③ The number of vessel in single villus of the investigate was more than the control. The area ratio of vessel to villus was smaller than the control(P0.05). ④ The incidence ratio of fetal distress in the investigate was 55.0%, the control was 11.1%. It suggests that the chorangiosis of placenta is caused in pregnant women by hepatitis B virus(HBV) infection, which is the main reason of fetal distress in uterus

Key words: hepatitis B, placenta, chorangiosis, fetal distress

李海燕, 陈瑞芬, 王小平, 周光德, 杨虹, 赵艳, 崔丹, 李珊, 韩超. 乙型肝炎病毒感染孕妇胎盘绒毛病理形态研究[J]. 首都医科大学学报, 2004, 25(4): 441-445.

Li Haiyan, Chen Ruifen, Wang Xiaoping, Zhou Guangde, Yang Hong,Zhao Yan, Cui Dan, Li Shan, H an Chao. Morphologic Change of Villus and Analysis of Fetal Distress in Pregnancy with Hepatitis B Virus Infection[J]. Journal of Capital Medical University, 2004, 25(4): 441-445.

[1]	张雪娟, 吴静, 张闻平, 周齐, 杨敬春. 经腹三维超声产前诊断胎盘植入的临床应用价值[J]. 首都医科大学学报, 2019, 40(5): 781-785.
[2]	周平, 刘程, 王秋石, 朱志清, 曹广明, 刘崇东, 张震宇. 人胎盘间充质干细胞治疗小鼠流产的效果研究[J]. 首都医科大学学报, 2019, 40(3): 434-438.
[3]	耿明凡, 高方媛, 李玉鑫, 张群, 刘尧, 王宪波. 抗病毒药物联合中医药治疗对慢性乙型肝炎e抗原血清转化率的影响[J]. 首都医科大学学报, 2018, 39(6): 810-814.
[4]	王铁征, 武聚山, 孟凡坤, 臧运金, 林栋栋, 李剑, 李宁. 瞬时弹性测定对无创诊断早期乙型肝炎相关肝硬化的价值评价[J]. 首都医科大学学报, 2017, 38(2): 299-303.
[5]	方芳, 陈柯霖, 陈燕, 黄泽玉, 吕虹, 刘淑静, 周金, 张国军, 康熙雄. 应用CNAS CL-36标准评估HBV DNA定量检测试剂的抗干扰能力[J]. 首都医科大学学报, 2016, 37(4): 495-499.
[6]	孔丽君, 周莉, 杨丽, 范玲. 产前超声检查和磁共振成像对胎盘植入诊断的准确性评估[J]. 首都医科大学学报, 2016, 37(2): 238-240.
[7]	许元龙, 杨仙珊, 刘凯燕, 易银, 李群辉, 黄晓婕, 郭彩萍, 吴昊. 北京男男性接触人群性传播感染HIV/HBV现状及相关因素研究[J]. 首都医科大学学报, 2014, 35(1): 96-100.
[8]	罗岚蓉, 李坚. 中期引产胎盘植入的诊断与治疗[J]. 首都医科大学学报, 2013, 34(4): 623-628.
[9]	李晓涛;魏立业;任运军;李强;夏杨;夏岳;郭喜朝. 血清胎盘生长因子与冠状动脉侧支循环的关系[J]. 首都医科大学学报, 2012, 33(6): 833-836.
[10]	李菁华;高凤云;李晓菲;吴青青. 胎盘绒毛膜血管瘤超声征象对比研究[J]. 首都医科大学学报, 2012, 33(1): 26-29.
[11]	胡虹英;刘颖;杨金奎. 2型糖尿病合并乙型肝炎病毒携带患者的临床分析[J]. 首都医科大学学报, 2011, 32(5): 602-604.
[12]	常路丝;乔雍;魏洪莲;肖凡;郝晓花;张仁雯;成军;魏红山. HBV相关分泌蛋白c18orf54的克隆表达及初步功能研究[J]. 首都医科大学学报, 2011, 32(3): 318-323.
[13]	张鑫#;武彦宁#;张大可;董培玲;范春蕾;李磊;丁惠国. 慢性HBV感染患者bcp/pc区点突变模式、pres区缺失及其临床意义[J]. 首都医科大学学报, 2011, 32(3): 324-330.
[14]	张贵利;李强;李友生;谭丽杰;张宏;刘丽红. 乙型肝炎肝硬化患者血清脂联素浓度与相关因素的关系[J]. 首都医科大学学报, 2010, 31(6): 792-794.
[15]	王慧;贾继东. 慢性HBV感染自然史及治疗对转归的影响[J]. 首都医科大学学报, 2010, 31(5): 582-585.