解脲支原体感染与胎膜早破及其羊膜MMP-9表达的关系

Correlations between ureaplasma urealyticum infection and premature rupture of membranes,expression of MMP-9 in amnion in pregnant women

目的探讨解脲支原体(UU)感染与胎膜早破(PROM)及羊膜上基质金属蛋白酶9(MMP-9)表达的相关性。方法应用荧光定量PCR(FQ-PCR)技术对30例胎膜早破孕妇(PROM组)和30例非胎膜早破孕妇(对照组)宫颈分泌物进行UU定量检测,同时对其胎膜用免疫组化SP法测定MMP-9。结果PROM组UU感染率:早产胎膜早破组(PPROM组)72.73%(8/11),足月胎膜早破组(TPROM组)57.89%(11/19);对照组UU感染率为20.00%(6/30)。PROM组MMP-9免疫组化(IH)积分为4.88±0.53,对照组为2.72±0.69,2组比较有显著性差异(P<0.01);PROM组的UU的对数值(LgUU)和MMP-9IH积分相关系数为0.672(P<0.01)。UU定量≥1.00×105cp/μl时,PROM的发生率为86.36%,与<1.00×105cp/μl时(对照组)比较有显著差异(P<0.01),并且PROM组的LgUU明显高于对照组(P<0.01)。孕妇PROM的发生与宫颈UU感染及胎膜MMP-9高表达有关,而MMP-9的高表达又与宫颈LgUU明显相关。结论孕妇宫颈UU感染和羊膜MMP-9高表达是PROM的重要原因,UU通过影响胎膜的MMP-9表达,使胶原降解增高,导致PROM。

Objective To study the correlations between ureaplasma ureaiyticum（UU） infection and premature rupture of membranes （PROM） ,expression of matrix metailopruteinase 9 （MMP-9） in amnion of pregnant women. Methods Thirty pregnant women with PROM were selected as PROM group which subdivided into preterm PROM group （PPROM, 11 cases） and term PROM group （TPROM, 19 cases）. Thirty pregnant women without PROM were selected as control group. The UU in cervical secretions were detected by fluorescence quantitative polymerase chain reaction （FQ-PCR） technique in all 60 cases of pregnant women. At the same time, the expressions of MMP-9 of fetal membranes were detected by immunohistochemicai （1H） assay （ streptavidin-perioxidas method） . Results The incidence of UU infection was 63.3% （19/30） in PROM group, in which 72.73% （8/11 ） in PPROM and 57.89% （11/19 ） in TPROM respectively, but 20% （6/30） in control group. There was significant difference between PROM group and control group （ P 〈 0. 05 ）. The IH score of MMP-9 was 4. 88 ± 0. 53 in PROM, but 2. 72 ± 0. 69 in control group. There was high significant difference between two groups （P 〈 0. 01 ）. The logarithm of UU （LgUU） and the 1H score of MMP-9 had close correlation in PROM group （ r = 0. 672, P 〈 0. 01 ）, and LgUU of PROM group conpared with control group had statistical significance（6. 22 ± 0. 59 vs 5.28 ±0.51, P 〈 0. 01 ）. The higher expression of MMP-9 had obvious correlation with LogUU. Conclusions Cervical UU infection and higher expression of MMP-9 in tmmion are important factors to cause PROM. The cervical UU concentration is close correlatine with higher expression of MMP-9 in amnion in PROM. UU infection can lead to PROM by influencing expression of MMP-9 in amnion.