MMP-9和iNOS在胎膜早破胎膜组织中的表达及相关性研究

Relationship between MMP-9 and iNOS expression in fetal membranes from the patients with premature rupture of the membranes

目的:探讨基质金属蛋白酶-9(MMP-9)和诱导型一氧化氮合酶(iNOS)在胎膜早破胎膜组织中的表达及相关性。方法:选择2010年4月-2011年1月我院在临产前行剖宫产终止妊娠的孕妇60例,分为早产胎膜早破组(pPROM)、足月胎膜早破组(tPROM)和正常足月妊娠组(对照组),每组各20例,采用免疫组织化学方法检测胎膜中MMP-9和iNOS的表达,分析其差异性及相关性;同时取静脉血及羊水,应用ELISA法进行MMP-9定量检测;采用HE染色检测胎膜,分析MMP-9、iNOS与绒毛膜羊膜炎的关系。结果:MMP-9在tPROM组和pPROM组胎膜组织、母血及羊水中的表达水平均高于对照组(P<0.01),iNOS在pPROM组胎膜中的表达水平高于对照组(P<0.01)。绒毛膜羊膜炎孕妇胎膜中的MMP-9(P<0.05)和iNOS(P<0.01)表达水平均高于非绒毛膜羊膜炎,二者呈正相关(P<0.01)。结论:MMP-9和iNOS表达升高与pPROM及绒毛膜羊膜炎的发生相关;MMP-9和iNOS在PROM发病机制中存在关联作用。

AIM：To investigate the expression levels of matrix metalloproteinase-9（MMP-9） and inducible nitric oxide synthase（iNOS） in the fetal membranes from the patients with premature rupture of the membranes（PROM）,and to analyze the relationship between the MMP-9 and iNOS expression.METHODS： Sixty pregnant women who had delivered by cesarean section before labor in the Third Affiliated Hospital of Sun Yat-sen University from April 2010 to January 2011 were enrolled in the study and were divided into 3 groups： term premature rupture of the membranes group（tPROM）,preterm premature rupture of the membranes group（pPROM）,and control group（healthy term pregnancy）.Immuno histochemical method was used to detect the expression levels of MMP-9 and iNOS,and analyze their variability and relevance.The level of MMP-9 were detected in serum and amniotic fluid by enzyme-linked immunosorbent assay（ELISA）.Fetal membranes were identified by hematoxylin eosin staining to determine infectious group and noninfectious group.The relationship between MMP-9/iNOS expression and chorioamnionitis was also analyzed.RESULTS： The expression levels of MMP-9 in fetal membrane cells,serum and amniotic fluid in tPROM group and pPROM group were higher than those in control group（P〈0.01）.The expression level of iNOS in pPROM group was higher than that in control group（P〈0.01）.The expression levels of MMP-9（P〈0.05） and iNOS（P〈0.01） in the patients with chorioamnionitis were higher than those in the patients without chorioamnionitis.MMP-9 in the fetal membranes had positive correlation with iNOS（r=0.476,P〈0.01）.CONCLUSION： The overexpression of MMP-9 and iNOS may correlate with pPROM and chorioamnionitis.MMP-9 and iNOS may play associative roles in the process of premature rupture of the membranes.