基质金属蛋白酶-3在早产发动机制中的作用研究  

Effect of matrix metalloproteinase-3 on preterm delivery mechanism

作　　者：王芬[1] 朱桃花[1] 康莉[1] 李如霞[1] 曹云霞[2] 魏兆莲[2] 

机构地区：[1]安徽省铜陵市妇幼保健院妇产科,244000 [2]安徽医科大学第一附属医院

出　　处：《中国妇幼保健》2013年第18期2997-3001,共5页Maternal and Child Health Care of China

基　　金：安徽省铜陵市卫生局科研基金〔200617〕

摘　　要：目的:通过检测孕产妇血清及胎盘胎膜中的基质金属蛋白酶-3(MMP-3)水平,探讨其在宫缩发动及胎膜早破中的可能作用机制。方法:选择单胎、头位、初产妇280例作为研究对象,按孕周、胎膜是否破裂和是否临产分为7组:早产临产组、早产胎膜早破组、先兆早产组、足月临产组、足月胎膜早破组、妊娠28～36+6周无任何产兆组(未足月对照组,对照组Ⅰ)、足月妊娠无产兆择期剖宫产组(足月对照组,对照组Ⅱ)。用ELISA法检测孕妇血清中的MMP-3水平,用免疫组化SP法检测胎盘胎膜组织中的MMP-3表达情况。结果:血清MMP-3的平均水平为(212.58±63.03)ng/ml,早产临产组和早产胎膜早破组血清MMP-3水平均高于先兆早产组和对照组Ⅰ(P<0.05);足月临产组和足月胎膜早破组血清MMP-3水平均高于对照组Ⅱ(P<0.05);相关未足月组和足月组之间相比,早产临产组和足月临产组血清MMP-3水平比较差异有统计学意义(P<0.05)。胎盘MMP-3免疫积分在临产组及胎膜早破组升高(P<0.05);胎膜MMP-3免疫积分在早产组表达增加,在各胎膜早破组较同孕期临产组明显升高(P<0.05)。血清MMP-3水平与胎盘胎膜MMP-3水平呈正相关。结论:血清及胎盘胎膜中MMP-3的高表达可能参与早产的发动。Objective：To evaluate the expression level of matrix metalloproteinases-3（MMP-3）in maternal serum,placental tissues and fetal membranes as a mechanism of preterm delivery and preterm premature rupture of membranes.Methods：A cross-sectional study was conducted with 280 women in the following categories：①preterm labour with intact membranes（n=40）;②preterm premature rupture of membranes（n=40）;③threatened preterm labor without delivery（n=40）;④term in labor（n=40）;⑤term premature rupture of membranes（n=40）;⑥be pregnant 28-36＋6 weeks not in labour（control group I,n=40）;⑦term not in labor with elective caesarean sections（control group Ⅱ,n=40）.MMP-3 in maternal serum was detected by enzyme-linked immunoabsorbent assay（ELISA）.The expression of MMP-3 in the placenta and fetal membranes was examined by immunohistochemical assay（SP）.Results：① There was significant difference in the level of MMP-3 between group preterm labour with intact membranes,preterm premature rupture of membranes and group threatened preterm labor without delivery,control group I（P〈0.05）;The level of MMP-3 in group term in labor and term premature rupture of membranes was significant higher in term in labor group than that of control groupⅡ（P〈0.05）;② There were significant differences in immunohistochemical score（IH score） of MMP-3 in the placenta among preterm labour with intact membranes,preterm premature rupture of membranes,threatened preterm labor without delivery,term premature rupture of membranes groups（P〈0.05）;IH score of MMP-3 in fetal membranes was significant higher in term in labor group than that of preterm labour with intact membranes,threatened preterm labor without delivery and preterm premature rupture of membranes groups（P〈0.05）.③ There was strongly positive correlation between the expression of MMP-3 in the placenta and the the levels of MMP-3 in maternal serum（P〈0.05）.Conclusion：The high expression of MMP-3 in maternal serum,

关 键 词：基质金属蛋白酶-3 血清 胎盘 胎膜 早产临产 早产胎膜早破 

分 类 号：R714.21[医药卫生—妇产科学]