基质金属蛋白酶及其组织抑制物在胎盘、血浆中的表达及其意义

目的:研究基质金属蛋白酶及其组织抑制物在胎盘和妊娠期疾病患者血浆中的表达。方法:应用免疫组化方法检测60例胎盘(妊高征27例,糖尿病15例,胆汁淤积症7例,对照11例)中MMP-9及MMP-2、TIMP-1、TIMP-2和38例(妊高征27例,对照11例)血浆中MMP-9、TIMP-1的表达。结果:正常妊娠胎盘中MMP-9和MMP-2表达最为明显,而妊娠高血压和糖尿病患者MMP-9、MMP-2表达都偏低,且MMP-2更为显著,而胆汁淤积症患者,虽然MMP-9表达与正常胎盘中无差异,但MMP-2、TIMP-1、TIMP-2表达都明显偏低。妊高征患者血浆MMP-9水平显著低于正常对照组,血浆TIMP-1水平显著高于正常对照组,血浆MMP-9/TIMP-1比值显著低于正常对照组。结论:MMP-9、MMP-2、TIMP-1、TIMP-2的协同偏低表达与妊娠期高血压疾病、妊娠期糖尿病、妊娠期肝内胆汁淤积症的发病有一定的关联性。

Expressions and significance of matrix metalloproteinase and its tissue inhibitor in placenta and plasma

Objective:To study the expressions of matrix metalloproteinase (MMP) and its tissue inhibitor (TIMP) in placenta and plasma of patients with pregnant diseases.Methods:The expression levels of MMP-9,MMP-2,TIMP-1 and TIMP-2 in 60 placental samples (27 cases of hypertensive disorder complicating pregnancy,15 cases of diabetes mellitus,7 cases of cholestasis,11 normal cases) and the expression levels of MMP-9 and TIMP-1 in plasma of 38 cases (27 cases of hypertensive disorder complicating pregnancy,11 normal cases) were detected by immunohistochemical method.Results:The expression levels of MMP-9 and MMP-2 were high in normal placentae,but their levels were low in patients with gestational hypertension and diabetes mellitus,especially MMP-2;there was no significant difference in MMP-9 expression level in placenta between cases with cholestasis and normal cases,but the expression levels of MMP-2,TIMP-1 and TIMP-2 in cases with cholestasis were significantly lower than those in normal cases;the expression level of MMP-9 and the ratio of MMP-9/TIMP-1 in plasma of cases with hypertensive disorder complicating pregnancy were significantly lower than those in normal cases,while the expression level of TIMP-1 in plasma was significantly higher than that in normal cases.Conclusion:The synergetic low expressions of MMP-9,MMP-2,TIMP-1 and TIMP-2 are related to hypertensive disorder complicating pregnancy,gestational diabetes mellitus and intrahepatic cholestasis of pregnancy.