前置胎盘患者胎盘组织中MMP-9、VEGF的表达水平及意义

Expression levels and significance of MMP-9 and VEGF in placental tissue of patients with placenta previa

目的研究前置胎盘患者胎盘组织中基质金属蛋白酶(MMP-9)和血管内皮生长因子(VEGF)表达水平,探讨其与临床参数的关系。方法选取2015年8月-2017年2月菏泽市定陶区人民医院确诊的87例前置胎盘患者为研究组,其中完全性前置胎盘、部分性前置胎盘和边缘性前置胎盘患者各29例。另选取该院正常孕晚期孕妇29例为对照组。采用免疫组织化学SP法检测两组胎盘组织中MMP-9和VEGF的表达情况,并研究其与前置胎盘临床病理参数的关系及两者表达的相关性。结果完全性前置胎盘组织、边缘性前置胎盘与对照组胎盘组织中MMP-9阳性表达率总体比较差异有统计学意义(P<0.05),两两比较显示,完全性前置胎盘组织中MMP-9阳性表达率(31.03%)明显低于边缘性前置胎盘(68.97%)和对照组(79.31%)(P<0.05);完全性前置胎盘组织、边缘性前置胎盘与对照组胎盘组织中VEGF阳性表达率总体比较差异有统计学意义(P<0.05),两两比较显示,完全性前置胎盘和部分性前置胎盘组织中VEGF阳性表达率(34.48%、58.62%)显著低于对照组(89.66%)(P<0.05);完全性前置胎盘组织中VEGF阳性表达率(34.48%)显著低于边缘性前置胎盘(82.76%)(P<0.05)。不同年龄、生育史、剖宫产史的前置胎盘患者胎盘组织中MMP-9和VEGF阳性表达率差异有统计学意义(P<0.05),有无吸烟史患者差异无统计学意义(P>0.05)。前置胎盘患者胎盘组织中MMP-9和VEGF表达呈正相关(r=0.427,P<0.05)。结论前置胎盘患者胎盘组织中MMP-9和VEGF的阳性表达率随病情的发展逐渐降低,且两者表达呈正相关。MMP-9和VEGF是前置胎盘发生发展中的重要参数,有可能成为诊断前置胎盘的潜在指标。

Objective To research the expression levels of matrix metalloproteinase-9（ MMP-9） and vascular endothelial growth factor（ VEGF） in placental tissue of patients with placenta previa,explore the relationships with clinical parameters. Methods From August2015 to February 2017,87 patients diagnosed as placenta previa definitely in People＇s Hospital of Dingtao District were selected as study group,including 29 patients with total placenta praevia,29 patients with partial placenta praevia,and 29 patients with marginal placental previa. Twenty-nine normal late pregnant women during the same period were selected as control group. Immunohistochemical SP method was used to detect the expression levels of MMP-9 and VEGF in placental tissue in the two groups. The relationships between MMP-9,VEGF and clinicopathological parameters of placenta previa and the correlation between MMP-9 and VEGF were analyzed. Results There was statistically significant difference in positive expression rate of MMP-9 between total placenta praevia group,marginal placental previa group and control group（ P〈0. 05）. The positive expression rate of MMP-9 in total placenta praevia group was 31. 03%,which was statistically significantly lower than that in marginal placental previa group（ 68. 97%） and control group（ 79. 31%）（ P〈0. 05）. There was statistically significant difference in positive expression rate of VEGF between total placenta praevia group,marginal placental previa group and control group（ P〈0. 05）. The positive expression rates of VEGF in total placenta praevia group and partial placenta praevia group were34. 48% and 58. 62%,respectively,which were statistically significantly lower than that in control group（ 89. 66%）（ P〈0. 05）. The positive expression rate of VEGF in total placenta praevia group was 34. 48%,which was statistically significantly lower than that in marginal placental previa group（ 82. 76%）（ P〈0. 05）. Among the patients with placental previa,there were statistically significant differences in the positive expression rates of MMP-9 and VEGF in placental tissue among the patients in different age groups,with different childbearing hostory and cesarean section history（ P〈0. 05）,but there was no statistically significant difference between the patients with smoking history and the patients without smoking history（ P〉0. 05）. Among the patients with placental previa,there was a positive correlation between MMP-9 expression and VEGF expression in placental tissue（ r = 0. 427,P〈0. 05）. Conclusion The positive expression rates of MMP-9 and VEGF in placental tissue of patients with placenta previa decrease with the aggravation of the disease,and MMP-9 expression is positively correlated with VEGF expression. MMP-9 and VEGF are important parameters of occurrence and development of placenta previa,which may be potential indexes in diagnosis of placenta previa.