胎膜早破患者胎膜组织中TNF-α、MMP-2的表达变化及意义

Expression changes of TNF-α and MMP-2 in fetal membrane tissues of patients with premature rupture of fetal membranes

目的观察肿瘤坏死因子α(TNF-α)、基质金属蛋白酶(MMP)-2在胎膜早破(PROM)患者胎膜组织中的表达及相关性,进一步探讨PROM发病机制。方法应用免疫组化技术(SP法)检测41例PROM孕妇胎膜组织中TNF-α、MMP-2表达,其中足月后胎膜早破22例(tPROM组)、未足月胎膜早破19例(pPROM组)。同时,随机选取足月未临产行择期剖宫产产妇20例为对照组。结果①tPROM组和pPROM组产妇胎膜组织的绒毛膜滋养细胞、羊膜上皮细胞的胞质均有TNF-α、MMP-2阳性表达,其中绒毛膜中的阳性表达程度强于羊膜。②tPROM组和pPROM组绒毛膜组织中TNF-α、MMP-2的表达无显著差异,均显著高于对照组(P均<0.05)。③tPROM组TNF-α和MMP-2的表达呈显著正相关(r=0.872,P<0.05),pPROM组和对照组两指标表达无明显相关性(r=0.35,P>0.05)。结论 PROM孕妇胎膜组织中存在TNF-α、MMP-2高表达,可能为导致PROM(尤其是tPROM)发生的重要因素。

Objective To observe the expression change＇s of tumor necrosis factor-α （TNF-α） and matrix metallo proteinase 2 （MMP-2） in fetal membrane tissues of patients with premature rupture of fetal membranes （PROM） and further to investigate the pathogenesis. Methods The expression of TNF-α and MMP-2 was detected by S-P immuno histochemistry in 61 cases of pregnant women including 22 women （ not in labor） with full-term PROM （ tPROM group）, 19 women （ not in labor） with preterm PROM （ pPROM group） and 20 women （ not in labor） with intact membranes （ the control group）. Results ①There was different positive expression of TNF-α and MMP-2 in chori onic nourish cells, amniotic epithelial cells in tPROM and pPROM groups, but the expression in serosa was stronger than amniotie membrane.②No significant difference was found in the expression of TNF-α and MMP-2 between the tPROM group and pPROM group, but the expression of the two groups was higher than that of the control group （ all P 〈 0.05）. ③There were positive correlations between TNF-α and MMP-2 in the tPROM group （r = 0. 872, P 〈 0.05 ） , while no significant correlation between them was found in the pPROM and control groups （ r = 0.35, P 〉 0.05 ）. Conclusion There is high expression of TNF-α and MMP-2 in fetal membrane tissues of patients with PROM, which may lead to the occurrence of PROM （ especially tPROM）.