子痫前期孕妇胎盘组织中MMP-9和ET-1表达水平及其与预后相关性分析

Expressions of MMP-9 and ET-1 in Placenta Tissues of Pregnant Women with Preeclampsia and Their Correlations with Prognosis

目的探讨基质金属蛋白酶-9(MMP-9)和内皮素-1(ET-1)在子痫前期(PE)孕妇胎盘组织中表达水平及其与孕妇预后的相关性。方法选取2013年5月—2017年5月分娩的268例孕妇作为研究对象,采用回顾性分析法分析所有孕妇的临床资料,根据是否存在PE分为对照组(正常孕妇) 184例和观察组(PE孕妇) 84例,检测2组MMP-9、ET-1等相关临床指标,分析其与预后的关系。结果观察组总胆固醇(TC)、肌酐(SCr)和尿酸(UA)升高率高于对照组,MMP-9阳性表达率低于对照组,ET-1阳性表达率高于对照组(P <0. 05)。非条件多因素logistic回归模型分析结果显示年龄过大、MMP-9过低表达和ET-1过高表达是导致PE孕产妇出现不良预后的独立危险因素(P <0. 05)。结论 MMP-9的过低表达和ET-1的过高表达均为导致PE孕妇出现不良预后的独立危险因素,临床上对于PE孕妇应密切监测其MMP-9和ET-1等相关指标水平,以降低不良结局的发生率。

Objective To investigate expressions of matrix metalloproteinase-9 （MMP-9） and endothelin-1 （ ET-1 ） in placenta tissues of pregnant women with preeclampsia （PE） and their correlations with prognosis. Methods Clinical data of 268 pregnant women delivered during May 2013 and May 2017 was analyzed by retrospective analysis method, and the patients were divided into control group （normal pregnant women, u = 184） and observation group （PE pregnant women, u = 84） according to whether or not having PE. Clinical indexes such as MMP-9 and ET-1 expressions were detected, and their correlations with prognosis were analyzed. Results Compared with those in control group, in observation group, elevated rates of total cholesterol （TC）, serum creatinine （$Cr） and uric acid （UA） were significant- ly higher, and positive expression rate of MMP-9 was significantly lower, while positive expression rate of ET-1 was signif- icantly higher （P 〈 0.05）. Non-conditional multivariate logistic regression analysis showed that overage, over-low- MMP- 9 expression and over-high ET-1 expression were independent risk factors of poor prognosis in pregnant women with PE （P 〈 0.05）. Conclusion Over-low MMP-9 and over-high ET-1 expressions are independent risk factors of poor progno- sis in PE pregnant women, and therefore, clinicians should closely monitor related clinical indexes such as MMP-9 and ET-1 in order to reduce incidence rate of adverse outcomes.