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目的:探讨MMP-9、TIMP-2、TGF-β1联合检测在胎膜早破中的意义。方法:用免疫组化法和RT-PCR法分别检测20例足月胎膜早破产妇(PROM组)、21例足月临产经阴道分娩产妇(足月分娩组)及23例足月未临产择期剖宫产妇(未临产组)胎膜组织中MMP-9、TIMP-2、TGF-β1的分布和表达变化。结果:PROM组胎膜中MMP-9表达阳性率显著高于足月分娩组和未临产组,3组间差异有统计学意义(P<0.01);未临产组胎膜中TIMP-2和TGF-β1表达强度最高,足月分娩组次之,PROM组最低,3组间差异有统计学意义(P<0.05)。PROM组胎膜中MMP-9mRNA表达最高,足月分娩组次之,未临产组最低;而未临产组胎膜中TIMP-2mRNA和TGF-β1mRNA表达最高,足月分娩组次之,PROM组最低,3组间差异有统计学意义(P<0.05)。胎膜上的TGF-β1表达水平和MMP-9表达呈负相关(P<0.05),与TIMP-2表达呈正相关(P<0.05)。结论:胎膜早破的发生和MMP-9/TIMP-2比例失衡有一定关系,胎膜上的TGF-β1可通过调控MMP-9及TIMP-2的表达引起MMP-9/TIMP-2比例失衡,增加胎膜细胞外基质的降解,最终导致胎膜早破发生。
Objective: To investigate the significance of joint detection of MMP-9, TIMP-2 and TGF-β1 in premature rupture of membranes. Methods: Twenty preterm premature rupture of membranes (PROM group), 21 full term vaginal delivery women (full term delivery group) and 23 full term nonterm labor were detected by immunohistochemistry and RT- Changes and distribution of MMP-9, TIMP-2 and TGF-β1 in fetal membranes of elective cesarean section (non-labor group). Results: The positive rate of MMP-9 in PROM group was significantly higher than that in term delivery group and non-labor group (P <0.01). The TIMP-2 and TGF β1 expression intensity of the highest, full-term delivery group followed, PROM group lowest, the difference between the three groups was statistically significant (P <0.05). PROM group had the highest expression of MMP-9mRNA, followed by full-term delivery group and lowest in non-labor group, while TIMP-2mRNA and TGF-β1mRNA were highest in PROM group, followed by full-term delivery group and PROM group , The difference between the three groups was statistically significant (P <0.05). The expression of TGF-β1 in fetal membranes was negatively correlated with the expression of MMP-9 (P <0.05), and positively correlated with the expression of TIMP-2 (P <0.05). Conclusion: The occurrence of premature rupture of membranes is related to the imbalance of MMP-9 / TIMP-2 ratio. TGF-β1 on the fetal membrane can cause the ratio of MMP-9 / TIMP-2 through regulating the expression of MMP-9 and TIMP- Imbalance, increase the degradation of fetal membranes extracellular matrix, eventually leading to premature rupture of membranes.