胎儿生长受限胎盘病理改变与绒毛滋养细胞基质金属蛋白酶9的表达关系

Relationship Between Matrix Metalloproteinase-9 Expression in Syncytiotrophoblast and Placenta Pathological Change of Intrauterine Growth Restriction

目的 了解胎儿生长受限 (fetal growth restriction,FGR)者胎盘病理改变与胎盘组织中基质金属蛋白酶 9(MMP- 9)表达水平变化的关系。 方法 选取我院 2 0 0 1年 1～ 9月分娩的 FGR患者及正常妊娠妇女胎盘各 30例 ,常规 HE染色及 PAS染色 ,观察胎盘形态学变化。另取 FGR及正常胎盘各 5例 ,5 0 0 H型透射电镜观察。利用免疫组化的方法对胎盘组织切片染色 ,观察 FGR胎盘绒毛组织滋养细胞 MMP- 9表达情况。 结果 FGR组中 2 2例胎盘有明显病理改变 ,发生率为73.33% ,FGR组绒毛间质纤维化及纤维蛋白样坏死绒毛 (6 3.3% )、绒毛血管减少 (70 .0 % )、合体结节增生 (4 3.3% )、细胞滋养细胞增生 (5 0 .0 % )均明显高于对照组 (分别为 6 .7%、10 .0 %、3.3%和13.3% ) (P<0 .0 1) ;电镜发现蜕膜螺旋动脉内皮损伤 ,管腔狭窄 ,部分动脉末端闭塞。有病理改变的胎盘绒毛滋养细胞 MMP- 9的表达 (18.2 % )明显低于无病理改变胎盘 (75 .0 % ) ,差异有非常显著性(P<0 .0 1)。 结论 FGR时胎盘发生了明显的病理改变 ,这种病理改变与胎盘中 MMP- 9的异常表达密切相关。

Objective To study the relationship between matrix metalloproteinase-9 in syncytiotrophoblast and placenta pathological change of fetal growth restriction. Methods The placental samples were collected from 30 patients with FGR and 30 normal pregnant women who delivered in our hospital from January 2001 to September 2001. The tissue sections were dealt with HE stain and PAS stain and then observed by microscope to find the morphological change. 5 another samples from each group were observed by 500H model electron microscope. Immunohistochemical analysis was employed to demonstrate the positive expression of the MMP-9 in syncytiotrophoblast of FGR placenta. Results There are significantly pathological change in 22 placentas of FGR and abnormal rate is 73.33%. The count of stroma fibrosis and fibrinoid necrosis of villi(63.3%), villous vascular decrease and gore(70.0%), villous syncytial knots(43.3%), cytotrophoblasts increase(50.0%) were more significant in the placenta of FGR group than that of normal group(6.7%,10.0%,3.3%,13.3%)(P<0.01) . The decidua spiral arteries endodermis damnification, arteries cavity straitness and part of arteries extremity obstruction were found by electron microscope. In pathological placentas, there are significantly lower expression of MMP-9 in syncytiotrophoblast (18.2%)than those without pathological change(75.0%,P<0.01). Conclusion There are significantly pathological change in placenta of FGR and it has a consanguineous relationship with abnormal expression of MMP-9 in syncytiotrophoblast.