子宫平滑肌中缝隙连接变化及CX43表达与子宫收缩乏力性产后出血关系的研究

摘要

目的：研究子宫平滑肌组织中缝隙连接（Gap junctions，GJs）数量变化及连接蛋白（Connexin，CX）43表达与子宫收缩乏力性产后出血的关系。方法采用1∶1病例对照研究方法，选择在我院行择期剖宫产产妇60例（宫缩乏力性产后出血者及同期无产后出血者各30例）。采用透射电镜定量检测产妇子宫下段平滑肌组织中GJs数量变化。分别采用RT-PCR技术及蛋白免疫印迹（Western blotting）技术检测子宫下段平滑肌组织中CX43mRNA及其蛋白表达水平。结果子宫收缩乏力性产后出血组产妇子宫下段平滑肌组织中GJs数量及CX43mRNA及其蛋白表达水平均小于无产后出血组，差异均有统计学意义（P＜0.05）。结论子宫下段平滑肌组织中GJs数量减少、CX43表达降低与子宫收缩乏力性产后出血发病密切相关。%Objective To discuss the significance of gap junctions and connexin 43 in the pathogenesis of postpartum hemorrhage(PPH)caused by uterine atony.Methods A case-control 1:1 observational study was conducted. 60 cases of elective cesarean section were selected in our hospital (the same period of uterine atony postpartum hemorrhage without postpartum hemorrhage in 30 cases). Transmission electron microscopic was used to detect the quantity of gap junctions. RT-PCR was used to detecte the level of CX43 mRNA in myometrium,western blotting was used determined the CX43 protein level.Results The number of GJs and the expression of CX43mRNA and protein in the smooth muscle of lower uterine segment of postpartum hemorrhage group were lower than those without postpartum hemorrhage, the difference was statistically significant(P<0.05).ConclusionThe expression of CX43 and quantity of gap junctions in myometrium are lower than that of their controls,and there is close correlation between expression and contractile function. Decreases of gap junctions and lower exprssion of CX43 in myometrium may be closely related to atony PPH.