MMPs和SAA在未足月胎膜早破发病机制中的作用

The Role of Maternal Serum MMPs and SAA in the Pathogenesis of Preterm Premature Rupture of Membranes

目的探讨金属基质蛋白-1(matrix metalloproteinase-1,MMP-1)、金属基质蛋白-3(matrix metalloproteinase-3,MMP-3)、金属基质蛋白-9(matrix metalloproteinase-9,MMP-9)和SAA(serum amyloid A,SAA)与未足月胎膜早破的关系。方法选择昆明医科大学第一附属医院产科住院未足月胎膜早破产妇30例、足月胎膜早破产妇30例、同期正常足月妊娠者30例作为对照。经ELISA(Enzyme-linked immunosorbent assay)法检测3组孕妇外周血中MMP-1、MMP-3、MMP-9及SAA水平,将3组孕妇胎盘组织进行病理学检测判断是否存在组织学绒毛膜羊膜炎。结果(1)MMP-1、SAA在PPROM(preterm premature rupture of membranes)组、PROM(premature rupture of membranes)组患者外周血中含量较对照组明显升高(P<0.05),两两比较后,MMP-1和SAA在PPROM组中含量较PROM组明显升高(P<0.05)。而MMP-3在PPROM组中含量明显高于PROM组和对照组(P<0.05),但在PROM组和对照组间的浓度差异无统计学意义(P>0.05);MMP-9在3组孕妇之间的浓度差异无统计学意义(P>0.05);(2)PROM组70%(21/30)、PROM组33.3%(10/30)、对照组33.3%(10/30)。PPROM组产妇胎盘组织学绒毛膜羊膜炎阳性率较PROM组和对照组更高,差异有统计学意义(χ2=10.841,P<0.05)。PROM组与对照组的差异无统计学意义(P>0.05)。结论孕妇的血清MMP-1、MMP-3、SAA均与未足月胎膜早破并发早期绒毛膜羊膜炎有关。

Objective To investigate the relationships of matrix metalloproteinase-1(MMP-1),matrix metalloproteinase-3(MMP-3),matrix metalloproteinase-9(MMP-9)and serum amyloid A(SAA)with the premature rupture of membranes.Methods Thirty cases of premature rupture of fetal membranes,30 cases of fullterm premature rupture of fetal membranes and 30 cases of full-term pregnancies were chosen as controls.The levels of MMP-1,MMP-3,MMP-9 and SAA in the peripheral blood of the three groups of pregnant women were measured by ELISA.The placental tissues of the three groups of pregnant women were examined pathologically to determine the presence of histological chorioamnionitis.Results(1)The levels of MMP-1 and SAA of PPROM and PROM groups were significantly higher than those of the control group(P<0.05).After the comparison,MMP-1 and SAA of the PPROM group were significantly more than those of the PROM group(P<0.05).However,the content of MMP-3 in PPROM group was significantly higher than that in PROM group and the control group(P<0.05),but there was no significant difference in the concentration between PROM group and the control group(P>0.05).There was no significant difference in the concentration of MMP-9 among the three groups(P>0.05).(2)70%(21/30)in the PROM group,33.3%(10/30)in the PROM group and 33.3%(10/30)in the control group.The histological positivity rate of placenta in the PPROM group was elevated compaired with that in the PROM and control groups,and the difference was statistically significant(χ2=10.841,P<0.05).There was no significant difference between the PROM and control groups(P>0.05).Conclusion Serum MMP-1,MMP-3 and SAA are closely associated with the premature rupture of membranes complicated by early chorioamnionitis.