联合检测母血MMP-9、IL-6预测胎膜早破、亚临床绒毛膜羊膜炎的临床意义

Clinical significance of combined detection of maternal serum levels of MMP-9,IL-6 in predictions of premature rupture of membranes and subclinical chorioamnionitism

目的:通过检测胎膜早破孕妇母血、胎膜组织中MMP-9、IL-6的表达水平,探讨其与胎膜早破、亚临床绒毛膜羊膜炎的相关性,探索预测和诊断亚临床绒毛膜羊膜炎的可行性的生物学指标。方法:ELISA方法检测胎膜早破及对照组孕妇血清MMP-9、IL-6的水平,同时取胎膜破口边缘处胎膜,采用免疫组化法(SP法)检测MMP-9、IL-6在胎膜上的表达;且病理检查确定有无组织学绒毛膜羊膜炎。结果:①胎膜早破孕妇血清MMP-9、IL-6水平明显高于正常对照组;②胎膜早破组胎膜中MMP-9、IL-6表达明显高于正常对照组;③母体血清MMP-9浓度为82.97 pg/ml时,IL-6浓度为46.38 pg/ml时,可作为预测临床绒毛膜羊膜炎的阈值。结论:MMP-9、IL-6可作为预测胎膜早破、合并亚临床绒毛膜羊膜炎的可行性生物学指标,联合检测更有利于早期诊断和预测。

Objective Through detect the expression of MMP -9, IL -6 in maternal serum and fetal membrane in pregnant woman with premature rupture of membranes ,to approach the relationship between them, premature rupture of membranes and subclinical chodoamnion- itism,the feasibility of biological indicators to anticipate and diagnose subclinical chorioamnionitis. Methods Women with premature rup- ture of membranes and normal women were studied, expression of MMP - 9, IL - 6 in maternal serum were measured by enzyme - ]inkedim- munosorbent assay. At the same time,the expression of MMP -9, IL -6 in fetal membranes, which collected from the edge of fetal mem- branes rupture membranes ,were detected by immunohistochemical method （SP）. Chorioamnionitis were diagnosed by histopatholo^cally Results （!） The lever of MMP -9 ,IL -6 in maternal serum in pregnant woman with premature rupture were significantly higher than that in the control group. @）The lever of MMP- 9 ,IL- 6 in fetal membranes were significantly higher in pregnant woman with premature rup- ture of membranes than in women in controls. （~Maternal serum MMP - 9 lever 82. 97 pg/ml ng/ml ,IL - 6 lever 46. 38 pg/ml ng/ml were regarded as the diagnosis threshold value of the subclinical chorioamnionitis. Conclusion serum MMP -9 ,IL -6 lever is a useful biological indicators for early detection of premature rupture of membranes and subclinical chorioamnionitis. And Joint detection is more conducive to early diagnosis and prediction.