未足月胎膜早破患者胎盘胎膜组织Toll样受体2的表达及其意义

Expression and significance of Toll like receptor 2 in placenta and fetal membrane tissue in patients with preterm premature rupture of membranes

目的探讨Toll样受体2(TLR-2)在未足月胎膜早破(PPROM)患者胎盘胎膜组织中的表达及其意义。方法选取2015年2月至2016年12月诊治的PPROM患者60例作为PPROM组,及同期正常分娩孕妇60例作为对照组,采用实时荧光定量聚合酶链反应(qRT-PCR)法检测两组对象胎膜组织TLR-2 mRNA表达,免疫组化法检测两组胎盘胎膜组织TLR-2蛋白表达。结果 PPROM组胎膜组织中TLR-2 mRNA相对表达量为0.612±0.130,明显高于对照组的0.324±0.122(P<0.01);PPROM组胎盘组织和胎膜组织TLR-2蛋白表达的平均光密度值分别为0.152±0.011和0.443±0.009,均明显高于对照组的0.080±0.006和0.276±0.005(P均<0.01);在PPROM组,胎膜TLR-2蛋白平均光密度值依破膜时间<16 h→破膜时间16~24 h→破膜时间>24 h之序递升,总体比较及两两比较差异均有统计学意义(P均<0.01);PPROM组绒毛膜羊膜炎发生率为23.33%,明显高于对照组的3.33%(P<0.01);PPROM组发生绒毛膜羊膜炎患者胎膜TLR-2蛋白平均光密度值明显高于非绒毛膜羊膜炎患者(P<0.01)。结论 PPROM患者胎盘胎膜组织TLR2表达上调,可能在胎膜破裂过程中有一定的作用。

Objective To investigate the expression of Toll like receptor 2 （TLR-2） in placenta and fetal membrane tissue in patients with preterm premature rupture of membranes （PPROM） and its significance. Methods Sixty cases of PPROM patients who received treatment from February 2015 to December 2016 were selected as PPROM group, and 60 cases of normal pregnant women at the same period were selected as control group. Quantitative real time polymerase chain reaction （qRT-PCR） was used to detect the expression of TLR-2 mRNA in fetal membrane tissue, and immunohistochemistry was used to detect the expression of TLR-2 protein in placenta and fetal membrane tissue respectively. Results The relative expression level of TLR-2 mRNA in PPROM group fetal membrane tissue was higher than that in control group （0.612 ± 0. 130 vs0O. 324 ± 0.122, P 〈 0.01 ）. The average optical density （AOD） values of TLR- 2 protein in placenta and fetal membrane tissue of PPROM group were all higher than those of control group （0. 152 ± 0. 011 vs 0. 080 ± 0. 006,0.443 ± 0. 009 vs 0. 276 ± 0. 005, all P 〈 0. 01 ）. In PPROM group, the AOD value of TLR-2 protein in fetal membrane tissue was increased according to the rupture 〈 16 h, 16 -24 h, 〉 24 h ascending order, and there were statistically differences in overall comparison and paired comparison （ all P 〈 0. 01 ）. The incidence of chorioamnionitis in PPROM group was higher than that in control group（23.33% vs 3.33% ,P 〈0.01 ）. In PPROM group,the AOD value of TLR-2 protein was higher in fetal membrane tissue patients with ehorioamnionitis than that with non-chorioamnionitis （P 〈 0.01 ）. Conclusion The increase of TLR-2 expression in placenta and fetal membrane tissue of PPROM patients may play a role in the progress of rupture of membranes.