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目的探讨基质金属蛋白酶-9(MMP-9)、肿瘤坏死因子-α(TNF-α)在妊娠期高血压疾病(简称妊高征)发病机制中的作用。方法采用免疫组化法检测57例妊高征患者和24例正常妊娠产妇胎盘绒毛上皮组织中MMP-9、TNF-α的表达。结果轻度妊高征组MMP-9的阳性表达与对照组相比,差异无显著性(P>0.05),而中、重度妊高征组阳性表达明显弱于正常妊娠组(P<0.01),且中、重度妊高征组间比较差异也有显著性(P<0.05)。对照组与轻、中、重度妊高征患者胎盘组织TNF-α表达水平比较,差异有显著性,(分别为P<0.05、P<0.01、P<0.01),且妊高征组中不同程度组间比较,差异也有极显著性(P<0.01)。对照组和轻度妊高征组,MMP-9与TNF-α表达无相关性(r=0.287、P>0.05及r=0.382、P>0.05),但中、重度妊高征患者,MMP-9与TNF-α表达水平存在显著的负相关性(r=-0.563、P<0.05及r=-0.681、P<0.01)。结论妊高征患者MMP-9表达下降,胎盘不完全侵入,胎盘局部缺血、缺氧,TNF-α表达增多,可能是引发妊高征的原因之一。
Objective To investigate the role of matrix metalloproteinase-9 (MMP-9) and tumor necrosis factor-α (TNF-α) in the pathogenesis of hypertensive disorder complicating pregnancy (referred to as PIH). Methods Immunohistochemistry was used to detect the expression of MMP-9 and TNF-α in placenta villi of 57 pregnant women with PIH and 24 normal pregnant women. Results The positive expression of MMP-9 in mild PIH group was not significantly different from that in control group (P> 0.05), while the positive expression of MMP-9 in moderate and severe PIH group was significantly weaker than that of normal pregnancy group (P <0.01) , And the difference between the moderate and severe pregnancy-induced hypertension group was also significant (P <0.05). The levels of TNF-α in placental tissue between control group and mild, moderate and severe pregnancy-induced hypertension syndrome patients were significantly different (P <0.05, P <0.01, P <0.01, respectively) There was also a significant difference between groups (P <0.01). There was no correlation between the expression of MMP-9 and TNF-α in control group and mild PIH group (r = 0.287, P> 0.05 and r = 0.382, P> 0.05) There was a significant negative correlation between TNF-αand TNF-α (r = -0.563, P <0.05 and r = -0.681, P <0.01). Conclusion The expression of MMP-9 in patients with PIH is decreased, the placenta is not completely invaded, the placental ischemia, hypoxia and the expression of TNF-α are increased, which may be one of the causes of PIH.