Romero Roberto, Chaiworapongsa Tinnakorn, Espinoza Jimmy, Gomez Ricardo, Yoon Bo Hyun, Edwin Sam, Mazor Moshe, Maymon Eli, Berry Stanley
Perinatology Research Branch, National Institute of Child Health and Human Development, Wayne State University/Hutzel Hospital, Department of OB/GYN, Detroit, MI 48201, USA.
Am J Obstet Gynecol. 2002 Nov;187(5):1125-30. doi: 10.1067/mob.2002.127312.
The objective of this study was to determine whether the concentrations of matrix metalloproteinase-9 (MMP-9) in the fetal (fetal plasma and amniotic fluid) and maternal compartments (plasma) are different in patients presenting with preterm premature rupture of membranes (PROM) than in those with preterm labor and intact membranes.
Fetal plasma MMP-9, interleukin-1beta (IL-1beta), IL-6, soluble tumor necrosis factor receptors 1 (sTNF-R1) and 2 (sTNF-R2) were measured in fetuses with preterm labor and intact membranes (n = 96) and preterm PROM (n = 43). The concentrations of analytes were determined with sensitive and specific immunoassays. A P value <.05 was considered significant.
(1) The median fetal plasma MMP-9 concentration was significantly higher in fetuses with preterm PROM than in those with preterm labor (P =.035). (2) In contrast, fetal plasma IL-1beta, sTNF-R1, and sTNF-R2 were significantly higher in patients with preterm labor than in those with preterm PROM (IL-1beta, P =.01; sTNF-R1, P =.003; and sTNF-R2, P =.02). (3) The median amniotic fluid concentration of MMP-9 was higher in patients with preterm PROM than in those with preterm labor (P <.001).
Fetuses with preterm PROM have increased concentrations of an enzyme (MMP-9) implicated in the mechanism of membrane rupture but lower concentrations of IL-1beta, sTNF-R1, and sTNF-R2 than fetuses with preterm labor and intact membranes. A role for the fetus in the genesis of preterm PROM deserves consideration.
本研究的目的是确定胎膜早破（PROM）患者与早产且胎膜完整患者相比，胎儿（胎儿血浆和羊水）及母体部分（血浆）中基质金属蛋白酶-9（MMP-9）的浓度是否存在差异。
测定早产且胎膜完整（n = 96）和早产PROM（n = 43）胎儿的胎儿血浆MMP-9、白细胞介素-1β（IL-1β）、IL-6、可溶性肿瘤坏死因子受体1（sTNF-R1）和2（sTNF-R2）。采用灵敏且特异的免疫测定法测定分析物浓度。P值<.05被认为具有统计学意义。
（1）早产PROM胎儿的胎儿血浆MMP-9浓度中位数显著高于早产胎儿（P =.035）。（2）相比之下，早产胎儿的胎儿血浆IL-1β、sTNF-R1和sTNF-R2显著高于早产PROM患者（IL-1β，P =.01；sTNF-R1，P =.003；sTNF-R2，P =.02）。（3）早产PROM患者的羊水MMP-9浓度中位数高于早产患者（P <.001）。
早产PROM胎儿与早产且胎膜完整的胎儿相比，参与胎膜破裂机制的一种酶（MMP-9）浓度升高，但IL-1β、sTNF-R1和sTNF-R2浓度较低。胎儿在早产PROM发生中的作用值得考虑。
