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目的探讨母血及脐血中环氧合酶-2(COX-2)、基质金属蛋白酶9(MMP-9)及金属蛋白酶组织抑制物1(TIMP-1)水平与胎膜早破关系。方法对胎膜早破组(62例)及对照组(62例)母血、脐血用ELISA法检测,并行胎膜组织病理检查。结果与对照组相比,胎膜早破组COX-2、MMP-9水平较高(P<0.05);TIMP-1水平较低(P<0.05);随破膜时间延长,COX-2、MMP-9水平升高,TIMP-1水平下降。与非绒毛膜羊膜炎组相比,绒毛膜羊膜炎组COX-2、MMP-9水平较高(P<0.05);TIMP-1水平较低(P<0.05)。胎膜早破组母血中MMP-9水平和COX-2呈正相关(P<0.05),和TIMP-1呈负相关(P<0.05)。结论母血、脐血中COX-2、MMP-9水平异常升高及TIMP-1显著下降,是胎膜早破发病的重要机制,检测其水平有利于胎膜早破的预测和诊断。
Objective To investigate the relationship between the levels of cyclooxygenase-2 (COX-2), matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1) in maternal and umbilical cord blood and premature rupture of membranes. Methods The maternal blood and umbilical cord blood samples of premature rupture of membranes group (62 cases) and control group (62 cases) were detected by ELISA, and the histopathological examination of fetal membranes was performed. Results Compared with the control group, the levels of COX-2 and MMP-9 were significantly higher in premature rupture of membranes (P <0.05) and lower in TIMP-1 levels (P <0.05) MMP-9 levels, TIMP-1 levels decreased. Compared with non-chorioamnionitis group, chorioamnionitis group COX-2, MMP-9 levels were higher (P <0.05); TIMP-1 levels were lower (P <0.05). Premature rupture of membranes in maternal serum MMP-9 levels and COX-2 was positively correlated (P <0.05), and TIMP-1 was negatively correlated (P <0.05). Conclusion The abnormally elevated levels of COX-2 and MMP-9 and the significant decrease of TIMP-1 in maternal blood and umbilical cord blood are the important mechanisms of premature rupture of membranes. Measuring the levels of COX-2 and MMP-9 may be helpful for the prediction and diagnosis of premature rupture of membranes.