羊水中明胶酶、白细胞介素8与胎膜早破关系的研究

Role of gelatinase and interleukin-8 in the pathogenesis of premature rupture of membrane

目的 探讨明胶酶、白细胞介素 8(interleukin 8,IL 8)与胎膜早破 (PrematureRuptureofMembrane,PROM)发生的关系。 方法 PROM者 30例为观察组 ,正常孕妇 30例为对照组。于剖宫产时抽取羊水 3ml备存。羊水消化生物素标记明胶 ,用ELISA法测定剩余明胶的含量 ,换算出酶的活性。参照文献进行明胶电泳 ,酶经电泳分离后 ,将该处的明胶消化 ,染色后形成不着色的透明带 ;IL 8含量的测定 :用双抗体夹心ELISA法。 结果 ( 1)在未临产、潜伏期和活跃期 ,观察组和对照组羊水总明胶酶的活性分别为 :( 85± 10 ) μg/L·12h、( 91± 7) μg/L·12h、( 10 4± 2 3) μg/L·12h和( 4 9± 15 ) μg/L·12h、( 5 8± 15 ) μg/L·12h、( 10 2± 2 9) μg/L·12h ,两组中活跃期显著高于未临产 (P <0 .0 1)。 ( 2 )在未临产期和潜伏期 ,观察组羊水中总明胶酶的活性均显著高于对照组 (P <0 .0 5 )。 ( 3)羊水中较明确的明胶酶带有 4条 ,分子量分别为 92、83、72和 6 6kd。观察组在未临产时羊水中各明胶酶消化的明胶带较对照组宽。 ( 4 )在未临产、潜伏期和活跃期 ,观察组和对照组羊水IL 8的含量分别为 :( 0 .195± 0 .110 ) μg/L、( 0 .2 76± 0 .12 8) μg/L、( 0 .333± 0 .134) μg/L和 ( 0 .10 2± 0 .0 5 6 ) μg/

Objective To study the role of Gelatinase and interleukin 8 (IL 8) in premature rupture of membrane (PROM). Methods Sixty pregnant women were divided into two groups. In the observation group, were the pregnant women ( n=30 ) complicated with PROM. The women whose membranes ruptured either normally or manually in cesarean delivery were in the control group. Activities of total gelatinases in amniotic fluid were calculated after the experiment of enzyme linked immunosorbent assay (ELISA) with actin labeled gelatin. The electrophoresis of gelatinase was taken according to reference. IL 8 was determined by sandwich ELISA. Results (1) The activity of total gelatinases of amniotic fluid in observation and control groups during the period before labor, latent stage and active stage were (85±10)μg/L·12 h, (91±7)μg/L·12 h, (104±23)μg/L·12 h, (49±15)μg/L·12 h, (58±15)μg/L·12 h and (102±29)μg/L·12 h respectively,the activity of total gelatinases in active stage was significantly higher than that before labor ( P <0.01).(2) The activity of total gelatinases in amniotic fluid in observation group was significantly higher ( P <0.05)than that in control group in terms of before labor or latent stage. (3) Four kinds of matrix metalloproteinases (MMP) were found by electrphoresis of amniotic fluid with the molecular weight of 92, 83, 72 and 66 kd respectively. The electrophoresis bands of observation group were wider than those in control group when they were before labor. (4) In terms of before labor , latent stage and active stage, the concentration of IL 8 in amniotic fluid of observation and control groups were(0.195±0.110)μg/L, (0.276±0.128)μg/L, (0.333±0.134)μg/L, (0.102±0.056)μg/L, (0.250±0.110)μg/L and (0.315 ±0.143)μg/L. The concentration of IL 8 in amniotic fluid in active stage was significantly higher than that before labor ( P <0.001). In latent stage and before labor, the concentration of IL 8 in observation group was much higher than that in control group ( P <0.05). Conclusion That the activity of gelatinase increased abnormally may play an essential role in the pathogenesis of PROM. Cytokines, including IL 8 may be important regulators of MMP by modulation of polymorphonuclear leukocytes.