基质金属蛋白酶-9在胎盘早剥中的表达及其意义

doi:10.3877/cma.j.issn.1673-5250.2014.04.027

目的

检测基质金属蛋白酶(MMP)-9在胎盘组织中的表达及其与胎盘早剥的关系。

方法

选择2012年9月1日至2013年9月30日于青岛市中心医院经阴道分娩或剖宫产术后示胎盘早剥者60例为研究对象，并纳入胎盘早剥组。按照胎盘早剥的严重程度，将其分为不典型胎盘早剥组(n = 30，I度)和典型胎盘早剥组(n = 30，Ⅱ度和Ⅲ度)。选择同期于本院经阴道分娩或剖宫产术后示正常胎盘者30例纳入对照组。3组产妇的年龄、体质量指数(BMI)、孕龄等比较，差异均无统计学意义(P>0.05)。采用免疫组化SP法检测胎盘组织中MMP-9的表达部位，蛋白免疫印迹法检测胎盘组织中MMP-9蛋白相对表达水平(本研究遵循的程序符合青岛市中心医院人体试验委员会制定的伦理学标准，得到该委员会批准，分组征得受试对象的同意，并与之签署临床研究知情同意书)。

结果

①胎盘早剥组和对照组胎盘组织中均有MMP-9的表达，并主要表达于合体滋养细胞的细胞核及细胞质中。胎盘早剥组胎盘组织中MMP-9阳性染色程度较对照组弱。②不典型胎盘早剥组和典型胎盘早剥组胎盘组织中MMP-9蛋白相对表达水平分别为和0.68±0.05和0.34±0.03，对照组为0.94±0.06，3组间两两比较，差异均有统计学意义(P< 0.01)。

结论

MMP-9可能通过影响滋养细胞侵袭力而参与胎盘早剥的发病，从而成为临床预测胎盘早剥的指标。

关键词: 胎盘早剥, 基质金属蛋白酶-9, 早期诊断

Objective

To evaluate the expression of matrix metalloproteinase (MMP)-9 in placental tissues and the relationship between the expression of MMP-9 and placental abruption.

Methods

From September 1st, 2012 to September 30th, 2013, a total of 60 cases with placental abruption were included into this study (placental abruption group). They were divided into two groups according to the degrees of placentas, atypical placental abruption group (n=30) and typical placental abruption group (n=30). At the same time, another 30 cases with normal placental tissue were included into control group. There had no significant differences on age,body mass index (BMI) and gestational age among three groups (P>0.05). Placentas were collected and detected by immunohistochemical SP method to detect the localization of MMP-9 protein. Western blot analysis was used to detected MMP-9 protein levels. The study protocol was approved by the Ethical Review Board of Investigation of Qingdao Centre Medical Hospital. Informed consent was obtained from all participates.

Results

① Expression of MMP-9 in placentas were found both in the placental abruption group and control group. MMP-9 positive immunostaining was apparently decreased in the placental abruption group when compared with control group. ② MMP-9 protein levels significantly decreased in the atypical placental abruption group and typical placental abruption group (0.68±0.05,0.34±0.03) when compared with control group(0.94±0.06), with statistically significant differences (P<0.01).

Conclusion

MMP-9 might be a clinical prediction of placental abruption.

Key words: Abruptio placentae, Matrix metalloproteinase 9, Early diagnosis

图1 MMP-9在胎盘早剥组和在正常胎盘中的表达情况(图1A：胎盘早剥组；图1B：对照组)(SP染色，×400)

Figure 1 Expression of MMP-9 in placental abruption and placenta (SP stain, ×400)

表1 3组间MMP-9蛋白相对表达水平的比较(±s)

Table 1 Comparison of MMP-9 protein relative expression among three groups(±s)

组别	n	MMP-9相对表达水平
不典型胎盘早剥组	30	0.68±0.05
典型胎盘早剥组	30	0.34±0.03
对照组	30	0.94±0.06
F		2.06
P		0.006 8

表1 3组间MMP-9蛋白相对表达水平的比较(±s)

Table 1 Comparison of MMP-9 protein relative expression among three groups(±s)

组别	n	MMP-9相对表达水平
不典型胎盘早剥组	30	0.68±0.05
典型胎盘早剥组	30	0.34±0.03
对照组	30	0.94±0.06
F		2.06
P		0.006 8

图2 蛋白免疫印迹法检测MMP-9在3组中的表达

Figure 2 MMP-9 expression was detected by Western in 3 groups

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Study on the Expression of Matrix Metalloproteinase-9 in Placental Abruption and Its Significance

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Study on the Expression of Matrix Metalloproteinase-9 in Placental Abruption and Its Significance