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目的 :探讨米非司酮对人胎儿心肌组织超微结构的影响。方法 :将中孕期引产的病例分为米非司酮组与对照组 ,每组各 5例 ,胎龄为 18～ 2 1孕周。米非司酮组在引产前 6h服用 150mg米非司酮 ,然后行水囊引产术 ,对照组则只行水囊引产术。胎儿娩出后 ,取心肌组织进行样品制备以供透射电镜观察。结果 :与对照组相比 ,在米非司酮引产的胎心肌组织可见下列形态改变 :( 1)心肌细胞水肿 ,线粒体明显肿胀 ;( 2 )胞质内糖原颗粒缺如 ;( 3)部分心肌细胞肌丝呈棉絮样改变 ,横纹消失 ;( 4 )间质可见溢出红细胞及血小板及其它细胞碎片。结论 :米非司酮可造成胎心肌组织缺氧性损伤。因此 ,使用米非司酮于晚期引产可能给新生儿造成心脏功能损伤的后遗症。
Objective: To investigate the effect of mifepristone on the ultrastructure of human fetal cardiac tissue. Methods: The cases of induced labor during the second trimester were divided into the mifepristone group and the control group, with 5 cases in each group. The gestational age ranged from 18 to 21 gestational weeks. Mifepristone group 6h before induction of labor taking 150mg mifepristone, and then the line of water bag induced abortion, the control group was only the water bag induced abortion. After delivery of the fetus, myocardial tissue was taken for sample preparation for transmission electron microscopy. RESULTS: Compared with the control group, the following morphological changes were observed in fetal heart muscle of mifepristone induced labor: (1) myocardial cell edema, obvious swelling of mitochondria; (2) lack of cytoplasmic glycogen granules; (3) Myocardial cell myofilament was cotton-like changes, horizontal stripes disappear; (4) interstitial spilled red blood cells and platelets and other cell debris. Conclusion: Mifepristone can cause hypoxic injury of fetal heart muscle tissue. Therefore, the use of mifepristone in late induction of labor may cause neonatal sequelae of cardiac dysfunction.