基质金属蛋白酶-9和白血病抑制因子在亚临床甲减稽留流产患者绒毛蜕膜组织中的表达及意义分析

Expression and significance of MMP-9 and LIF in chorion and decidua tissues of patients with subclinical hypothyroidism and missed abortion

目的分析基质金属蛋白酶-9(MMP-9)、白血病抑制因子(LIF)在亚临床甲减(SCH)稽留流产患者绒毛蜕膜组织中的表达及意义。方法选取2017年9月至2018年6月深圳龙华区人民医院行人工流产的SCH稽留流产25例,正常妊娠并自愿行人工流产的早孕患者25例(对照组),比较两组甲状腺功能检测指标、绒毛蜕膜组织MMP-9、LIF蛋白表达水平,对比不同孕周稽留流产者MMP-9、LIF蛋白表达水平,分析MMP-9、LIF水平与各指标相关性。结果观察组血清促甲状腺激素(TSH)水平高于对照组(P<0.05),两组游离T3(FT3)、游离T4(FT4)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TMAb)比较差异无统计学意义(均P>0.05);观察组绒毛蜕膜组织中MMP-9蛋白表达阳性率高于对照组,而LIF蛋白表达阳性率低于对照组(均P<0.05);观察组中孕周>10周者绒毛蜕膜组织中MMP-9蛋白表达阳性率高于孕周≤10周者,而LIF蛋白在孕周>10周者中表达水平更低(均P<0.05);Spearman相关分析显示,SCH稽留流产者绒毛蜕膜组织中MMP-9阳性率与TSH、孕周呈正相关,与LIF阳性率呈负相关,而LIF阳性率与TSH、孕周呈负相关(均P<0.05)。结论SCH稽留流产者绒毛蜕膜组织中,MMP-9高表达,而LIF低表达,且二者与SCH病变、孕周也有密切关系,两者共同导致SCH稽留流产的发生。

Objective To investigate the expression and significance of matrix metalloproteinase-9(MMP-9)and leukemia inhibitory factor(LIF)in chorion and decidua tissues of patients with subclinical hypothyroidism(SCH)and missed abortion.Methods Included in this study were a total of 25 patients with SCH and missed abortion(study group)who underwent artificial abortion in Longhua District People’s Hospital of Shenzhen between September 2017 and June 2018,as well as 25 patients in early pregnancy who volunteered to undergo artificial abortion(control group).Thyroid function indexes,expression levels of MMP-9 and LIF proteins in chorion and decidua tissues were compared between the two groups and among patients with missed abortion according to different gestational weeks.The correlation between MMP-9,LIF levels and each index was analyzed.Results Serum TSH level in the study group was higher than that in the control group(P<0.05).There was no significant differences in FT3,FT4,TGAb or TMAb levels between the two groups(P>0.05).In the study group,the positive expression rate of MMP-9 protein in chorion and decidua tissues was higher,while the positive expression rate of LIF protein was lower,compared with the control group(P<0.05).In the study group,the positive expression rate of MMP-9 protein in chorion and decidua tissues was higher,while expression level of LIF protein was lower,in patients with gestational weeks>10 weeks than in those with≤10-week gestation(P<0.05).Spearman correlation analysis showed that positive rate of MMP-9 in chorion and decidua tissue in patients with SCH and missed abortion was positively correlated with serum TSH and gestational weeks,while negatively correlated with positive rate of LIF.The positive rate of LIF was negatively correlated with serum TSH and gestational weeks(P<0.05).Conclusion In patients with SCH and missed abortion,chorionic and decidual MMP-9 is highly expressed while LIF is lowly expressed.The both are closely related to SCH severity and gestational weeks,and may concomitantly contribute to occurrence of SCH and missed abortion.