基质金属蛋白酶-9、Ⅲ型胶原、纤维黏连蛋白在胎膜早破发病机制中的作用  

Role of matrix metalloproteinases-9,collagen Ⅲ and fibronectin in premature rupture of fetal membranes

作　　者：田玲[1] 万敏[1] 王倩[1] 柏妍槟[1] 沈禾[1] 闫华[1] TIAN Ling;WAN Min;WANG Qian;BO Yan-bin;SHEN He;YAN Hua(Department of Obstetrics and Gynecology,The Third People＇s Hospital of Bengbu,Bengbu Anhui 233000,Chin)

机构地区：[1]安徽省蚌埠市第三人民医院妇产科,233000

出　　处：《蚌埠医学院学报》2018年第7期907-911,共5页Journal of Bengbu Medical College

基　　金：安徽省蚌埠市科技局计划项目[2010(51)]

摘　　要：目的:观察并检测基质金属蛋白酶-9(MMP-9)、Ⅲ型胶原、纤维黏连蛋白(FN)在胎膜早破孕妇血清及胎膜组织中的表达水平,探讨其参与胎膜早破的发病机制。方法:40例胎膜早破孕妇,其中未足月胎膜早破组(p PROM组,20例),足月胎膜早破组(tPROM组,20例),另外选取同期正常足月妊娠孕妇20名作为对照组。应用酶联免疫吸附试验及免疫组织化学方法检测血清及胎膜组织中MMP-9、Ⅲ型胶原、FN的表达水平,并对测定结果进行相关性分析。结果:3组孕妇血清MMP-9、Ⅲ型胶原、FN含量差异均有统计学意义(P<0.01),其中,tPROM组MMP-9显著高于p PROM组,后者又显著高于对照组(P<0.01);p PROM组Ⅲ型胶原、FN水平显著低于tPROM组,而后者又显著低于对照组(P<0.01)。MMP-9在p PROM组和tPROM组胎膜组织中的阳性表达率均高于对照组(P<0.05)。MMP-9在tPROM组胎膜组织中的阳性表达率高于p PROM组,但差异无统计学意义(P>0.05)。Ⅲ型胶原和FN在p PROM组和tPROM组胎膜组织中的阳性表达率均低于对照组(P<0.05)。Ⅲ型胶原和FN在tPROM组胎膜组织中的阳性表达率低于p PROM组,但差异无统计学意义(P>0.05)。在p PROM组和tPROM组中,MMP-9和Ⅲ型胶原的表达水平均呈负相关关系(r=-0.874,r=-0.988,P<0.01),MMP-9与FN的表达水平均呈负相关关系(r=-0.760,r=-0.875,P<0.01),Ⅲ型胶原与FN的表达水平均呈正相关关系(r=0.529,r=0.876,P<0.05)。在胎膜组织中,MMP-9和Ⅲ型胶原的表达水平呈负相关关系(r=-0.468,P<0.01),MMP-9和FN的表达水平呈负相关关系(r=-0.493,P<0.01),Ⅲ型胶原和FN的表达水平呈正相关关系(r=0.885,P<0.01)。结论:MMP-9、Ⅲ型胶原、FN参与胎膜早破的发生,孕妇血清及胎膜组织中MMP-9含量升高、Ⅲ型胶原和FN含量降低,这些因素均可能导致胎膜早破的发生。Objective： To observe the expression levels of matrix metalloproteinases-9（ MMP-9）,type Ⅲ collagen and fibronectin（ FN） in the serum and fetal membranes in women with premature rupture of membrane,and investigate their roles in premature rupture of membranes. Methods： Twenty women with preterm premature rupture of membranes,20 women with term fetal rupture of membranes and 20 women with normal full-term pregnancy were divided into the p PROM group,tPROM group and control group,respectively. The levels of MMP-9,type Ⅲ collagen and FN in the serum and fetal membranes in three groups were detected using the enzyme-linked immunosorbent assay and immunohistochemistry,and the results of those were analyzed. Results： The differences of the serum levels of MMP-9,type Ⅲ collagen and FN between three groups were statistically significant（ P〈0. 01）,the serum level of MMP-9 in tPROM group was significantly higher than that in p PROM group,and the serum level of MMP-9 in p PROM group was significantly higher than that in control group（ P〈0. 01）. The positive rates of MMP-9 in fetal membranes of p PROM group and tPROM group were significantly higher than that in control group（ P〈0. 01）,the positive rate of MMP-9 in tPROM group was significantly higher than that in p PROM group,and the difference of which between two groups was not statistically significant（ P〈0. 05）. The positive rates of type Ⅲ collagen and FN in fetal membranes of p PROM group and tPROM group were lower than that in control group（ P〈0. 01）,the positive rates of type Ⅲ collagen and FN in tPROM group was lower than that in p PROM group,and the difference of which between two group was not statistically significant（ P〈0. 05）. Among p PROM group and tPROM group,the level of MMP-9 was negatively related to the type Ⅲcollagen level（ r =-0. 874,r =-0. 988,P〈0. 01）,the level of MMP-9 was positively related to the FN level（ r =-0. 760,r=-0. 875,P〈0. 01）,and the level of type Ⅲ collagen was po

关 键 词：胎膜早破 基质金属蛋白酶-9 Ⅲ型胶原 纤维黏连蛋白 

分 类 号：R714.433[医药卫生—妇产科学]