胎膜早破患者基质金属蛋白酶-9及其底物水平表达
发布时间：2018-07-20 11:00
【摘要】：目的检测足月胎膜早破孕妇血浆锌、血清及羊水MMP-9、血清及羊水IV型胶原含量变化及胎膜IV型胶原表达水平，分析锌、MMP-9和IV型胶原之间的相关性，探讨基质金属蛋白酶-9及其底物水平与足月胎膜早破的关系，为胎膜早破的发病病因及预防提供理论依据。 方法选择自2012年11月-2013年3月我院确诊为足月胎膜早破患者30例作为病例组，另选择在同一时期足月分娩的非胎膜早破患者30例作为对照组，收集所有研究对象的孕母外周血、羊水及胎膜组织，分别应用原子吸收法检测血浆锌含量，应用ELISA法检测血清和羊水MMP-9含量、应用上转发光法检测血清和羊水IV型胶原含量，用免疫组化法检测病例组与对照组胎膜IV型胶原表达，应用奥林巴斯Bx63全自动显微镜扫描系统观察和扫描，比较病例组与对照组上述指标表达水平的差异，并对各指标之间的相关性进行分析。 结果1、胎膜早破组孕妇血浆锌含量平均为109.10umol/l,显著高于对照组，差异有统计学意义（P＜0.05）；胎膜早破组孕妇血清MMP-9含量平均为1463.25ng/ml，显著高于对照组，差异有统计学意义（P＜0.05），羊水MMP-9含量平均为125.48ng/ml，显著高于对照组，差异有统计学意义（P＜0.05）；胎膜早破组孕妇血清IV型胶原含量平均为56.86ng/ml，显著低于对照组，差异有统计学意义（P＜0.05）；胎膜早破组孕妇羊水IV型胶原含量明显高于正常对照组，P＜0.05，差异有统计学意义（P＜0.05）；2、孕妇血清MMP-9、羊水MMP-9之间有相关性，呈正相关（P＜0.05）；孕妇血浆锌、血清MMP-9之间有相关性，呈正相关（P＜0.05）；孕妇血浆锌与血清IV型胶原之间有相关性，呈负相关（P＜0.05）；孕妇血浆锌与羊水MMP-9、血清IV型胶原与血清MMP-9、血清IV型胶原与羊水MMP-9之间均无相关性（P＞0.05），孕妇血浆锌、血清IV型胶原与胎膜IV型胶原之间均无相关性（P＞0.05）；孕妇血清MMP-9、羊水MMP-9与胎膜IV型胶原之间有相关性，呈负相关（P＜0.05）；3、绒毛膜羊膜炎时，胎膜增厚，水肿，细胞增生严重、间质增宽。胎膜早破组绒毛膜羊膜炎感染率较对照组明显升高，，差异有统计学意义（P＜0.05）；胎膜早破组随破膜时间的逐渐延长，孕妇WBC计数明显升高，差异有统计学意义（P＜0.05）；4、IV型胶原主要分布于绒毛膜的基底层和羊膜的基底层，IV型胶原免疫组化染色位于细胞外，呈棕黄色束状和条索状；胎膜早破组孕妇胎膜IV型胶原含量平均为160.70，明显低于对照组，差异有统计学意义（P＜0.05）。 结论足月胎膜早破患者母体血浆锌、血清及羊水MMP-9含量升高、血清IV型胶原含量降低，胎膜IV型胶原表达降低。锌、MMP-9、IV型胶原和孕足月胎膜早破有关。
[Abstract]:Objective to detect the changes of plasma zinc, serum and amniotic fluid MMP-9, serum and amniotic fluid type IV collagen and the expression level of fetal membrane type IV collagen in pregnant women with term premature rupture of membranes, and to analyze the correlation between zinc and amniotic fluid type IV collagen. To explore the relationship between matrix metalloproteinase-9 and its substrate level and term premature rupture of membranes, to provide a theoretical basis for the etiology and prevention of premature rupture of membranes. Methods from November 2012 to March 2013, 30 cases of term premature rupture of membranes were selected as the case group, and 30 cases of non-fetal membrane premature rupture in the same period of term delivery as the control group. The peripheral blood of all the subjects were collected. In amniotic fluid and fetal membrane, plasma zinc content was detected by atomic absorption spectrometry, MMP-9 in serum and amniotic fluid was detected by Elisa, type IV collagen in serum and amniotic fluid was detected by up-conversion luminescence method. The expression of type IV collagen in fetal membrane was detected by immunohistochemical method, and the expression of type IV collagen was observed and scanned by Olympus Bx63 automatic microscope system. The difference of the expression level of the above indexes between the case group and the control group was compared. And the correlation between the indicators were analyzed. Results 1. The plasma zinc content in premature rupture group was significantly higher than that in control group (P < 0.05), and the serum MMP-9 level in premature rupture group was 1463.25 ng / ml, which was significantly higher than that in control group. The average content of MMP-9 in amniotic fluid was 125.48 ng / ml, which was significantly higher than that in the control group (P < 0.05), and the average level of type IV collagen in the pregnant women with premature rupture of membranes was 56.86 ng / ml, which was significantly lower than that in the control group. The content of type IV collagen in amniotic fluid of pregnant women with premature rupture of membranes was significantly higher than that of normal control group (P < 0.05), the difference was statistically significant (P < 0.05). There was a positive correlation between serum MMP-9 and MMP-9 in amniotic fluid (P < 0.05). There was a positive correlation between plasma zinc and serum MMP-9 in pregnant women (P < 0.05), and a negative correlation between plasma zinc and type IV collagen in pregnant women (P < 0.05). There was no correlation between plasma zinc and amniotic fluid MMP-9, serum type IV collagen and serum MMP-9, serum type IV collagen and amniotic fluid MMP-9 (P > 0.05). There was no correlation between maternal plasma zinc, serum type IV collagen and fetal membrane type IV collagen (P > 0.05). There was a negative correlation between MMP-9, MMP-9 in amniotic fluid and type IV collagen of fetal membrane (P < 0.05). In chorioamnionitis, membrane thickening, edema, cell proliferation and interstitial widening were observed. The infection rate of chorioamnionitis in the premature rupture group was significantly higher than that in the control group (P < 0.05), and the WBC count in the premature rupture group was significantly higher than that in the control group (P < 0.05). 4the immunohistochemical staining of type IV collagen mainly distributed in the basal layer of chorion and amniotic membrane was in the form of brown bundles and stripes, and the average content of type IV collagen was 160.70 in the group of premature rupture of membranes, which was significantly lower than that in the control group. The difference was statistically significant (P < 0.05). Conclusion the levels of plasma zinc, MMP-9 in serum and amniotic fluid in the patients with term premature rupture of membranes increased, the level of type IV collagen in serum decreased, and the expression of type IV collagen in membranes decreased. Type IV collagen was associated with premature rupture of membranes in term pregnancy.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.433
本文编号：2133309
[Abstract]:Objective to detect the changes of plasma zinc, serum and amniotic fluid MMP-9, serum and amniotic fluid type IV collagen and the expression level of fetal membrane type IV collagen in pregnant women with term premature rupture of membranes, and to analyze the correlation between zinc and amniotic fluid type IV collagen. To explore the relationship between matrix metalloproteinase-9 and its substrate level and term premature rupture of membranes, to provide a theoretical basis for the etiology and prevention of premature rupture of membranes. Methods from November 2012 to March 2013, 30 cases of term premature rupture of membranes were selected as the case group, and 30 cases of non-fetal membrane premature rupture in the same period of term delivery as the control group. The peripheral blood of all the subjects were collected. In amniotic fluid and fetal membrane, plasma zinc content was detected by atomic absorption spectrometry, MMP-9 in serum and amniotic fluid was detected by Elisa, type IV collagen in serum and amniotic fluid was detected by up-conversion luminescence method. The expression of type IV collagen in fetal membrane was detected by immunohistochemical method, and the expression of type IV collagen was observed and scanned by Olympus Bx63 automatic microscope system. The difference of the expression level of the above indexes between the case group and the control group was compared. And the correlation between the indicators were analyzed. Results 1. The plasma zinc content in premature rupture group was significantly higher than that in control group (P < 0.05), and the serum MMP-9 level in premature rupture group was 1463.25 ng / ml, which was significantly higher than that in control group. The average content of MMP-9 in amniotic fluid was 125.48 ng / ml, which was significantly higher than that in the control group (P < 0.05), and the average level of type IV collagen in the pregnant women with premature rupture of membranes was 56.86 ng / ml, which was significantly lower than that in the control group. The content of type IV collagen in amniotic fluid of pregnant women with premature rupture of membranes was significantly higher than that of normal control group (P < 0.05), the difference was statistically significant (P < 0.05). There was a positive correlation between serum MMP-9 and MMP-9 in amniotic fluid (P < 0.05). There was a positive correlation between plasma zinc and serum MMP-9 in pregnant women (P < 0.05), and a negative correlation between plasma zinc and type IV collagen in pregnant women (P < 0.05). There was no correlation between plasma zinc and amniotic fluid MMP-9, serum type IV collagen and serum MMP-9, serum type IV collagen and amniotic fluid MMP-9 (P > 0.05). There was no correlation between maternal plasma zinc, serum type IV collagen and fetal membrane type IV collagen (P > 0.05). There was a negative correlation between MMP-9, MMP-9 in amniotic fluid and type IV collagen of fetal membrane (P < 0.05). In chorioamnionitis, membrane thickening, edema, cell proliferation and interstitial widening were observed. The infection rate of chorioamnionitis in the premature rupture group was significantly higher than that in the control group (P < 0.05), and the WBC count in the premature rupture group was significantly higher than that in the control group (P < 0.05). 4the immunohistochemical staining of type IV collagen mainly distributed in the basal layer of chorion and amniotic membrane was in the form of brown bundles and stripes, and the average content of type IV collagen was 160.70 in the group of premature rupture of membranes, which was significantly lower than that in the control group. The difference was statistically significant (P < 0.05). Conclusion the levels of plasma zinc, MMP-9 in serum and amniotic fluid in the patients with term premature rupture of membranes increased, the level of type IV collagen in serum decreased, and the expression of type IV collagen in membranes decreased. Type IV collagen was associated with premature rupture of membranes in term pregnancy.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.433
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