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目的探讨Toll样受体2(TLR-2)在未足月胎膜早破(PPROM)患者胎盘胎膜组织中的表达及其意义。方法选取2015年2月至2016年12月诊治的PPROM患者60例作为PPROM组,及同期正常分娩孕妇60例作为对照组,采用实时荧光定量聚合酶链反应(qRT-PCR)法检测两组对象胎膜组织TLR-2 mRNA表达,免疫组化法检测两组胎盘胎膜组织TLR-2蛋白表达。结果 PPROM组胎膜组织中TLR-2 mRNA相对表达量为0.612±0.130,明显高于对照组的0.324±0.122(P<0.01);PPROM组胎盘组织和胎膜组织TLR-2蛋白表达的平均光密度值分别为0.152±0.011和0.443±0.009,均明显高于对照组的0.080±0.006和0.276±0.005(P均<0.01);在PPROM组,胎膜TLR-2蛋白平均光密度值依破膜时间<16 h→破膜时间16~24 h→破膜时间>24 h之序递升,总体比较及两两比较差异均有统计学意义(P均<0.01);PPROM组绒毛膜羊膜炎发生率为23.33%,明显高于对照组的3.33%(P<0.01);PPROM组发生绒毛膜羊膜炎患者胎膜TLR-2蛋白平均光密度值明显高于非绒毛膜羊膜炎患者(P<0.01)。结论 PPROM患者胎盘胎膜组织TLR2表达上调,可能在胎膜破裂过程中有一定的作用。
Objective To investigate the expression and significance of Toll-like receptor 2 (TLR-2) in fetal membranes of unprotected premature rupture of membranes (PPROM). Methods Sixty patients with PPROM diagnosed and treated from February 2015 to December 2016 were selected as PPROM group and 60 pregnant women with normal delivery during the same period as control group. Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) The expression of TLR-2 mRNA in fetal membranes and the expression of TLR-2 in fetal membranes of the two groups were detected by immunohistochemistry. Results The relative expression of TLR-2 mRNA in PPROM group was 0.612 ± 0.130, which was significantly higher than that in control group (0.324 ± 0.122, P <0.01). The average expression of TLR-2 protein in placenta and fetal membranes of PPROM group The density of TLR-2 protein in PPROM group was significantly lower than that in control group (P <0.01) Time <16 h → time of membrane rupture 16 ~ 24 h → time of membrane rupture> 24 h, there was a significant difference between the two groups (all P <0.01). The incidence of chorioamnionitis in PPROM group (23.33%), which was significantly higher than that of the control group (3.33%, P <0.01). The mean optical density of TLR-2 protein in chorioamnionitis patients was significantly higher than that in non-chorioamnionitis patients (P <0.01) . Conclusion The up-regulation of TLR2 in fetal membranes of PPROM patients may play a role in the rupture of membranes.