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目的:胎儿纤维连接蛋白(fFN)、基质金属蛋白酶9(MMP-9)、环氧化酶2(COX-2)在自发性早产患者胎盘组织中的表达及意义。方法:选择2012年12月至2013年6月在西京医院妇产科住院分娩的90例孕妇,其中自发性早产30例,足月顺产30例,择期剖宫产30例。采取免疫组化法、RT-PCR法检测胎盘组织中fFN、MMP-9、COX-2的表达。结果:(1)fFN、MMP-9、COX-2的阳性表达主要定位于滋养细胞胞浆。fFN、MMP-9、COX-2在自发性早产组的阳性表达率分别为96.7%、90%和93.3%,显著高于足月顺产组(86.7%、70%和83.3%)和择期剖宫产组(56.7%、46.7%和50%)(P<0.01);足月顺产组显著高于择期剖宫产组(P<0.01)。(2)fFN mRNA、MMP-9 mRNA、COX-2 mRNA在早产组中的表达水平显著高于足月顺产组、择期剖宫产组(P<0.01);足月顺产组显著高于择期剖宫产组(P<0.01)。结论:fFN、COX-2、MMP-9在自发性早产中呈高表达,推测其可能参与了自发性早产的发病过程。
Objective: To investigate the expression and significance of fetal fibronectin (fFN), matrix metalloproteinase 9 (MMP-9) and cyclooxygenase 2 (COX-2) in placenta of spontaneous preterm labor. Methods: From December 2012 to June 2013, 90 pregnant women were hospitalized in Xijing Hospital of Obstetrics and Gynecology, including 30 cases of spontaneous preterm labor, 30 cases of term full-term pregnancy and 30 cases of elective cesarean section. The expression of fFN, MMP-9 and COX-2 in placenta was detected by immunohistochemistry and RT-PCR. Results: (1) The positive expression of fFN, MMP-9 and COX-2 mainly located in the trophoblastic cytoplasm. The positive rates of fFN, MMP-9 and COX-2 in spontaneous preterm labor group were 96.7%, 90% and 93.3%, respectively, which were significantly higher than those in term full-term labor group (86.7%, 70% and 83.3% (56.7%, 46.7%, 50%) (P <0.01). The full-term cesarean section group was significantly higher than the elective cesarean section group (P <0.01). (2) The expression levels of fFN mRNA, MMP-9 mRNA and COX-2 mRNA in preterm labor group were significantly higher than those in full-term labor group and elective cesarean delivery group (P <0.01) Palace group (P <0.01). Conclusions: The expression of fFN, COX-2 and MMP-9 in spontaneous preterm labor is high, suggesting that they may be involved in the pathogenesis of spontaneous preterm labor.