【摘要】 目的:探讨基质金属蛋白酶-9(MMP-9)和诱导型一氧化氮合酶(iNOS)在胎膜早破胎膜组织中的表达及相关性。方法:选择2010年4月-2011年1月我院在临产前行剖宫产终止妊娠的孕妇60例,分为早产胎膜早破组(pPROM)、足月胎膜早破组(tPROM)和正常足月妊娠组(对照组),每组各20例,采用免疫组织化学方法检测胎膜中MMP-9和iNOS的表达,分析其差异性及相关性;同时取静脉血及羊水,应用ELISA法进行MMP-9定量检测;采用HE染色检测胎膜,分析MMP-9、iNOS与绒毛膜羊膜炎的关系。结果:MMP-9在tPROM组和pPROM组胎膜组织、母血及羊水中的表达水平均高于对照组(P<0.01),iNOS在pPROM组胎膜中的表达水平高于对照组(P<0.01)。绒毛膜羊膜炎孕妇胎膜中的MMP-9(P<0.05)和iNOS(P<0.01)表达水平均高于非绒毛膜羊膜炎,二者呈正相关(P<0.01)。结论:MMP-9和iNOS表达升高与pPROM及绒毛膜羊膜炎的发生相关;MMP-9和iNOS在PROM发病机制中存在关联作用。更多还原

【Abstract】 AIM:To investigate the expression levels of matrix metalloproteinase-9(MMP-9) and inducible nitric oxide synthase(iNOS) in the fetal membranes from the patients with premature rupture of the membranes(PROM),and to analyze the relationship between the MMP-9 and iNOS expression.METHODS: Sixty pregnant women who had delivered by cesarean section before labor in the Third Affiliated Hospital of Sun Yat-sen University from April 2010 to January 2011 were enrolled in the study and were divided into 3 groups: term premature rupture of the membranes group(tPROM),preterm premature rupture of the membranes group(pPROM),and control group(healthy term pregnancy).Immuno histochemical method was used to detect the expression levels of MMP-9 and iNOS,and analyze their variability and relevance.The level of MMP-9 were detected in serum and amniotic fluid by enzyme-linked immunosorbent assay(ELISA).Fetal membranes were identified by hematoxylin eosin staining to determine infectious group and noninfectious group.The relationship between MMP-9/iNOS expression and chorioamnionitis was also analyzed.RESULTS: The expression levels of MMP-9 in fetal membrane cells,serum and amniotic fluid in tPROM group and pPROM group were higher than those in control group(P<0.01).The expression level of iNOS in pPROM group was higher than that in control group(P<0.01).The expression levels of MMP-9(P<0.05) and iNOS(P<0.01) in the patients with chorioamnionitis were higher than those in the patients without chorioamnionitis.MMP-9 in the fetal membranes had positive correlation with iNOS(r=0.476,P<0.01).CONCLUSION: The overexpression of MMP-9 and iNOS may correlate with pPROM and chorioamnionitis.MMP-9 and iNOS may play associative roles in the process of premature rupture of the membranes.更多还原