作者：张米娜，于月成，黄侃，宋晖，张红菊，王晓红
【关键词】  早孕
    Protective effect of insulinlike growth factors on early pregnancy
　　【Abstract】 AIM: To detect the expressions of insulinlike growth factorⅠ (IGFI) in villus and IGFII in decidua and the levels in mother serum, and to explore their relationship with the embryogenesis of early pregnancy. METHODS: Expressions of IGFI and IGFII were examined by immunohistochemical SP method; the mRNA expressions of IGFI and IGFII were detected by in situ hybridization (ISH); serum IGFI and IGFII levels were determined by enzymelinked immunosorbent assay (ELISA). RESULTS: The expressions of IGFI and IGFII both protein and mRNA were lower in the abnormal villus and decidua of pregnancy termination than those of normal villus and decidua of normal pregnancy （P<0.01）. Serum levels of IGFI and IGFII in normal pregnancy women were much higher than those of abnormal pregnancy women（P<0.01）. CONCLUSION: IGFI and IGFII may play important roles in the regulation of fetal growth, the decrease of IGFI and IGFII levels in villus, decidua and serum may be the key factor contributing to the embryogenesis termination of early pregnancy. So IGF I and IGFII can serve as 2 parameters in examining the fetal safety.
　　【Keywords】 insulinlike growth factor I; insulinlike growth factor II; early pregnancy;  villus termination; deciduas
　　【摘要】 目的：探讨胰岛素样生长因子I和II（IGFI和II）在正常胚胎发育及早期胚胎发育终止绒毛及蜕膜组织中的表达及其在母体血中水平的改变与胚胎发育的关系. 方法：分别采用免疫组织化学SP法和原位杂交法检测正常胚胎发育绒毛及早期胚胎发育终止绒毛中IGFI和蜕膜中IGFII蛋白的表达以及IGFI mRNA和蜕膜中IGFII mRNA的表达；采用酶联免疫吸附试验（ELISA）检测正常妊娠及早期胚胎发育终止孕妇血中IGFI和II水平的变化. 结果：免疫组化结果显示，正常妊娠绒毛中IGFI和蜕膜中IGFII的表达明显高于胚胎发育终止组（P＜0.01）；原位杂交结果显示，正常妊娠组绒毛中IGFI和蜕膜中IGFII mRNA的表达明显高于胚胎发育终止组（P＜0.01）；正常妊娠组母血中IGFI和II水平显著高于胚胎发育终止组（P＜0.01）. 结论：IGFI和II在绒毛组织中的表达及母血中的水平的升高对早期胚胎发育有重要的保护作用，其含量的减少可能是导致胚胎死亡的重要原因之一. IGFI和II可能成为预测胎儿安危的指标之一.
　　【关键词】 胰岛素样生长因子I； 胰岛素样生长因子II； 早孕； 绒毛；蜕膜
　　0引言
　　近年来已有大量研究表明胚胎在宫内的生长发育是一个多因素调节的过程. Guidice等［1］证实胰岛素样生长因子I（IGFI）具有调节胎儿生长发育的作用，但是有关具体作用途径和作用机制尚不清，而子宫内膜中胰岛素样生长因子II（IGFII）的含量随月经周期而改变，并与卵巢激素的作用密切相关［2-3］，因此，推测IGFs在早期胚胎发育过程中可能起着重要作用. 我们通过检测正常胚胎发育孕妇及胚胎发育终止孕妇血中的IGFI水平和绒毛中的IGFI及蜕膜中IGFⅡ表达的变化，探讨IGFI和IGFⅡ对早期胚胎发育的保护作用.
　　1材料和方法
　　1.1材料选取200309/200410西京医院妇产科门诊48例经B超证实胚胎发育终止而行清宫术者的绒毛组织和蜕膜组织为实验组，56例因避孕失败而实施人工流产的绒毛组织