分娩时子宫下段MMP-9及其组织抑制剂TIMP-1的变化

Changes of matrix metalloproteinase-9 and its inhibi tor TIMP-1 in lower segment of uterine during delivery

目的 :探讨基质金属蛋白酶 (MMP)及其组织抑制剂 (TIMP)在分娩发动、宫颈成熟和扩张中的作用和机制。方法 :采用ELISA方法测定子宫下段组织中MMP 9和TIMP 1的浓度。有宫缩剖宫产组 5 6例 ,其中第一产程组4 4例 ,第二产程组 12例。以无宫缩剖宫产组 16例为对照组。结果 :有宫缩剖宫产组子宫下段组织中MMP 9和TIMP 1的浓度分别明显高于无宫缩剖宫产组 (P <0 .0 5 ,P <0 .0 5 )。第一产程组中随宫口开大 ,MMP 9和TIMP 1的浓度各组间无显著性差异。第二产程组MMP 9和TIMP 1的浓度分别明显高于第一产程组 (P <0 .0 1,P <0 .0 5 )。结论 :MMPs和TIMPs的动态变化是分娩发动、宫颈成熟和扩张过程中的重要中间环节。

Objective: To investigate the function and m echanism of matrix metalloproteinases (MMP) and tissue inhibitor of matrix metal loproteinases (TIMP) during of delivery, maturation and dilatation of uterine ce rvix in lower segment of uterus. Methods:The ELISA method was used. Fifty-six cases of cesarean section with uterine contraction are taken as experimental group, including 44 cases in the first stage and 12 cases in the s econd stage of labour. Sixteen cases of cesarean section without uterine contra ction are taken as controll group. Results: The concentrations of MMP-9 and TIMP-1 in lower segment tissue of uterine in the group of cesare an section with uterine contraction were significantly higher than those in the group of cesarean section without uterine contraction(F=5.53, P<0.05; F=11.18, P<0.05). In those in the first stage of labour, MMP-9 and TIMP- 1 increased with the dilatation of cervix; however, there was no significant dif ference among different groups. The MMP-9 and TIMP-1 in those in the second st age of labour significantly higher than those in the first stage of labour (F =30.78, P<0.01; F=23.60, P<0.05). Conclusion: Th e dynamic changes of MMPs and TIMPs are key in the onset of delivery, maturation and dilatation of uterine cervix.