Malaric placentas - A quantitative study and clinico-pathological correlations
Malaric placentas - A quantitative study and clinico-pathological correlations
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DOI：
10.1016/s0344-0338(96)80068-9
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发表时间：
1996-09-01
影响因子：
2.8
通讯作者：
Ghione, M
中科院分区：
文献类型：
--
作者：
Leopardi, O;Naughten, W;Ghione, M
对在桑给巴尔分娩的440个胎盘中的372个进行了组织学和形态学研究。用点计数法测定绒毛膜（F）、绒毛间隙（IVS）和绒毛（V）的相对体积，用直线截距法测定合胞体与毛细血管的比值。寄生虫血症负荷和炎症反应通过使用1 mm正方形网格进行半定量分级。寄生的红细胞识别活动性疟疾（AM），疟疾色素的存在仅识别东部疟疾（Phl），以及两者的缺乏表征非疟疾胎盘（Nhl）。AM（17.87%）、PM（21.61%）和NM（60.52%）胎盘重量差异不显著。来自AM的新生儿体重显著低于来自Pill和Nhl的新生儿。外周和胎盘寄生虫血症不一致。胎盘寄生虫血症负荷与出生体重平行增加。后者随着炎症严重程度的增加而下降，特别是随着IVS中淋巴细胞的流行。在AM和PM胎盘中发现了显著增加的体积，而在IVS和V体积中没有观察到显著变化。AM中合胞体/毛细血管比率显著增加。我们的结论是，低出生体重的疟疾与IVS炎症，但不F存款或寄生虫血症负荷。非白细胞趋化性淋巴因子可能起一定作用。形态学方面预示胎盘比预期的不成熟，这可能代表一种适应性变化。
A histological and morphometric study was conducted on 372 placentae out of a total 440 delivered in Zanzibar. Fibrin (F), intervillous space (IVS) and Villi (V) relative volumes were determined by the point-counting system and the ratio of syncytium to blood capillaries by the linear intercept method. Parasitemia load and inflammatory reaction were graded semiquantitatively by the use of a 1 mm square grid. Parasitised red cells identified active malaria (AM), the presence of malarial pigment only identified east malaria (Phl), and the absence of both characterized non-malarial placentae (Nhl). AM(17.87%), PM(21,61%) and NM(60.52%) placentae did not vary significantly in weight. Newborns from AM had a significantly lower weight than those from Pill and Nhl. Peripheral and placental parasitemia were not coincident. Placental parasitemia load increased parallel with birthweight. The latter decreased with the increasing severity of the inflammation, particularly with the prevalence of lymphocytes in the IVS. Significantly increased volume off was found in AM and PM placentae, while no significant variation was noticed in IVS and V volumes. The syncytium/capillaries ratio was significantly increased in AM. We conclude that low birthweight in malaria is linked to IVS inflammation but not to F deposits or parasitemia load. Non-leukotactic lymphokines might play some role. Morphologic aspects bespeak for a less mature placenta than expected and this might represent an adaptive change.