不同时间服用米非司酮对人绒毛组织MMPs/TIMPs表达的影响  

Effect of different time of mifepristone on the expression of MMPs/TIMPs of human chorion

作　　者：张俊勤[1] 李亚星[2] 韩华[1] ZHANG Junqin;LI Yaxing;HAN Hua(Department of Gynecology,Hebei General Hospital,Hebei,Shijiazhuang 050051,China;不详)

机构地区：[1]河北省人民医院妇科,石家庄市050051 [2]河北省人民医院肿瘤三科,石家庄市050051

出　　处：《河北医药》2023年第13期1960-1963,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20170254)。

摘　　要：目的观察米非司酮服用后不同时间对人早孕绒毛组织基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)、基质金属蛋白酶组织抑制途径因子-1(tissure inhibitor of metalloproteinase-1,TIMP-1)表达的影响,探讨缩短药物流产米非司酮与米索前列醇两药间隔的可行性。方法选取2019年9月至2021年5月收治的自愿要求终止早孕女性80例,随机分为对照组、12 h组、24 h组、48 h组4组,对照组直接采规负压吸引术终止妊娠,3个用药组顿服米非司酮150 mg,服用后12 h、24 h、48 h行负压吸引术,各组留取绒毛组织,应用免疫组织化学方法检测各组绒毛组织中MMP-2、MMP-9、TIMP-1的表达,比较不同组间临床基本资料、绒毛组织形态学、绒毛组织MMP-2、MMP-9、TIMP-1、MMP-9/TIMP-1平均光密度值,以及绒毛组织MMP-2、MMP-9、TIMP-1、TIMP-1表达情况差异。结果各用药组中MMP-2、MMP-9、MMP-9/TIMP-1比值表达均高于对照组,差异有统计学意义(P<0.05),而用药3组间表达差异无统计学意义(P>0.05)。各用药组中TIMP-1表达均低于对照组,差异有统计学意义(P<0.05),而用药组3组间表达差异无统计学意义(P>0.05)。结论米非司酮作用后12 h绒毛组织即发生变性坏死,MMP-2、MMP-9呈高表达,TIMP-1呈低表达,其影响与48 h相似,说明将米非司酮与米索前列醇用药间隔缩短至12 h理论上是可行的。Objective To observe the influence of mifepristone administration at different time points on expression levels of matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9)and tissue inhibitor of metalloproteinase-1(TIMP-1)in human chorion tissues,and to explore the feasibility of shortening the interval between mifepristone and misoprostol for medical abortion.Methods A total of 80 early pregnancy women who voluntarily requested termination in our hospital from September 2019 to May 2021 were randomly assigned into control group,12-hour group,24-hour group,and 48-hour group.Pregnancy was terminated by direct negative pressure aspiration.Subjects in 12-hour group,24-hour group,and 48-hour group took mifepristone 150 mg once,followed by negative pressure aspiration performed at 12,24 and 48 hours,respectively.Chorion tissues were collected.Immunohistochemistry was performed to detect expression levels of MMP-2,MMP-9,and TIMP-1 in chorion tissues.Baseline characteristics,morphology of chorion tissues,optical densities and expression levels of MMP-2,MMP-9,TIMP-1 and MMP-9/TIMP-1 among groups were compared.Results Expression levels of MMP-2,MMP-9,and MMP-9/TIMP-1 in 12-hour group,24-hour group,and 48-hour group were significantly higher than those in control group(all P<0.05),which were comparable among the three former groups(all P>0.05).Expression level of TIMP-1 in 12-hour group,24-hour group,and 48-hour group was significantly lower than that in control group(P<0.05),which was comparable among the three former groups(P>0.05).Conclusion After mifepristone treatment for 12 hours,chorion tissues are degenerated and necrosised,when MMP-2 and MMP-9 are upregulated,while TIMP-1 is downregulated.The outcomes at 12 hours are similar to those at 48 hours,suggesting that it is theoretically feasible to shorten the interval between mifepristone and misoprostol to 12 hours.

关 键 词：米非司酮 超微结构 基质金属蛋白酶 基质金属蛋白酶组织抑制途径因子 绒毛 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]