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目的探讨基质金属蛋白酶(MMP)9、2及基质金属蛋白酶抑制物(TIMP)1、2在胎盘粘连发生中的作用。方法选择孕足月分娩的胎盘粘连产妇23例作为胎盘粘连组,其中9例分娩后即刻取蜕膜组织作为蜕膜粘连组;正常足月分娩产妇28例作为正常胎盘组,其中11例分娩后即刻取蜕膜组织作为正常蜕膜组。应用实时定量聚合酶链反应(Real timePCR)技术检测4组产妇MMP9、MMP2、TIMP1、TIMP2mRNA表达水平。结果(1)胎盘粘连组及正常胎盘组产妇MMP9mRNA表达水平分别为(3.84±0.24)和(3.21±0.76)copy/μg,两组比较,差异有统计学意义(P<0.05);蜕膜粘连组及正常蜕膜组产妇MMP9mRNA表达水平分别为(3.81±0.66)和(2.50±0.49)copy/μg,两组比较,差异有统计学意义(P<0.05)。(2)胎盘粘连组及正常胎盘组产妇TIMP1mRNA表达水平分别为(5.92±0.46)和(5.91±0.56)copy/μg,两组比较,差异无统计学意义(P>0.05);蜕膜粘连组及正常蜕膜组产妇TIMP1mRNA表达水平分别为(6.63±0.51)和(7.09±0.55)copy/μg,两组比较,差异有统计学意义(P<0.05)。(3)胎盘粘连组及正常胎盘组产妇MMP2mRNA表达水平分别为(5.53±0.59)和(4.55±1.13)copy/μg,两组比较,差异有统计学意义(P<0.05);蜕膜粘连组及正常蜕膜组产妇MMP2mRNA表达水平分别为(6.07±0.83)和(5.97±0.76)copy/μg,两组比较,差异无统计学意义(P>0.05)。(4)胎盘粘连组及正常胎盘组产妇TIMP2mRNA表达水平分别为(4.69±0.60)和(3.79±1.06)copy/μg,两组比较,差异有统计学意义(P<0.05);蜕膜粘连组及正常蜕膜组产妇TIMP2mRNA表达水平分别为(5.06±0.33)和(3.98±0.60)copy/μg,两组比较,差异有统计学意义(P<0.05)。结论胎盘组织中MMP9、2升调节及其蜕膜组织中TIMP1降调节与胎盘粘连的发生有关;TIMP2在胎盘粘连发生中的作用尚待进一步研究。
Objective To investigate the role of matrix metalloproteinase (MMP) 9,2 and matrix metalloproteinase (TIMP) 1,2 in the pathogenesis of placental adhesion. Methods Twenty-three pregnant women with placenta accreta on term full-term delivery were selected as the placenta adhesion group. Nine of them received decidua immediately after childbirth as the decidual adhesion group. Among them, 28 were normal term delivery women, Immediate decidual tissue as the decidua group. The expression of MMP9, MMP2, TIMP1 and TIMP2 mRNA in four groups of maternal mothers was detected by real time quantitative PCR (Real time PCR). Results (1) The expression levels of MMP9 mRNA in placenta adhesion group and normal placenta group were (3.84 ± 0.24) and (3.21 ± 0.76) copy / μg respectively, with statistical significance (P <0.05) The levels of MMP9mRNA in maternal group and normal decidua group were (3.81 ± 0.66) and (2.50 ± 0.49) copy / μg, respectively. There was significant difference between the two groups (P <0.05). (2) The expressions of TIMP1 mRNA in placenta adhesion group and normal placenta group were (5.92 ± 0.46) and (5.91 ± 0.56) copy / μg respectively, there was no significant difference between the two groups (P> 0.05) (6.63 ± 0.51) and (7.09 ± 0.55) copy / μg, respectively. The difference between the two groups was statistically significant (P <0.05). (3) The expression levels of MMP2mRNA in placenta adhesion group and normal placenta group were (5.53 ± 0.59) and (4.55 ± 1.13) copy / μg respectively, with significant difference between the two groups (P <0.05) (6.07 ± 0.83) and (5.97 ± 0.76) copy / μg, respectively. There was no significant difference between the two groups (P> 0.05). (4) The expressions of TIMP2 mRNA in placenta adhesion group and normal placenta group were (4.69 ± 0.60) and (3.79 ± 1.06) copy / μg respectively, there was significant difference between the two groups (P <0.05) (5.06 ± 0.33) and (3.98 ± 0.60) copy / μg, respectively. The difference between the two groups was statistically significant (P <0.05). Conclusion The regulation of MMP9 and 2 levels in placenta and the down regulation of TIMP1 in decidua are related to the occurrence of placenta adhesion. The role of TIMP2 in placenta adhesion remains to be further studied.