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目的探讨检测孕妇血清中基质金属蛋白酶-9(MMP-9)和血清及羊水中肿瘤坏死因子-α(TNF-α)在诊断胎膜早破孕妇绒毛膜羊膜炎中的作用。方法选择2004-06-2004-12在汕头市潮南区人民医院和汕头大学医学院第一附属医院产科住院分娩的胎膜早破患者42例为研究组,并选择同期正常40例孕妇为对照组,采用酶联免疫吸附法和高敏感的放射免疫法检测血清的MMP-9和血清及羊水中的TNF-α水平,同时行产后胎膜病理检查。结果胎膜早破孕妇羊水中TNF-α和血清中MMP-9水平明显高于对照组,差异显著(P<0·05);但血清中的TNF-α与对照组比较差异无显著性(P>0·05)。血清中MMP-9水平在重度和轻中度绒毛膜羊膜炎组差异显著(P<0·05);而羊水中TNF-α差异无显著性(P>0·05)。结论测定母体血清的MMP-9含量和羊水中TNF-α水平,可作为胎膜早破患者是否患有绒毛羊膜炎的辅助诊断指标,尤其是血清的MMP-9含量的高低,还可以判定绒毛膜羊膜炎的严重程度。
Objective To investigate the role of matrix metalloproteinase-9 (MMP-9) in serum and amniotic fluid of serum and amniotic fluid of tumor necrosis factor-α (TNF-α) in the diagnosis of chorioamnionitis in pregnant women with premature rupture of membranes. METHODS: Forty-two patients with premature rupture of membranes of premature rupture of membranes in obstetrics and gynecology hospital of Chaonan District People’s Hospital of Shantou and the First Affiliated Hospital of Shantou University Medical College from 2004-06 to 2004-12 were selected as research group. Forty pregnant women of the same period as control The levels of serum MMP-9 and serum and amniotic fluid TNF-α were detected by enzyme-linked immunosorbent assay and high sensitive radioimmunoassay. Results The levels of TNF-α in amniotic fluid and MMP-9 in serum of pregnant women with premature rupture of membranes were significantly higher than those in control group (P <0.05). However, there was no significant difference between serum TNF- P> 0.05). The level of MMP-9 in serum was significantly different between severe and mild chorioamnionitis group (P <0.05), while there was no significant difference in amniotic fluid (P> 0.05). Conclusion Determination of maternal serum MMP-9 levels and amniotic fluid TNF-α levels, as a premature rupture of membranes in patients with chorioamnion-assisted diagnosis of indicators, especially the level of serum MMP-9 levels, but also to determine the villi The severity of amniotic membrane inflammation.