| Premature rupture of membranes ( PROM) is frequent in obstetrics that harm maternal and fetal health. Its incidence rate is from 3. 30% to 21. 9% of all women in labor. After the rupture of amnio membrane , it will cause serious result , such as amniotic infection, premature delivery , perinatal infection et al. But up to present, the cause and the underlying pathogenic mechanism is still unknown. It is believed in the lastest few years that matrix metalloproteinases ( MMPs) have a prodominent function for PROM followed by the deeply study of MMPs, in which the alteration of the activity of MMP -9 is in relation with PROM. But the relationshop between the plasma level of MMP ?9 in pregnant woman and PROM has not been reported in domestic and foreign country.Interleukin - 6 (IL - 6 ) is one of the family of inflammatory cell factors. It acted in a series of pathophysiologic process. It is believed that inflammatory cell factor control the activity of MMPs by deeply studied.This experiment using enzyme - linked immunosorbent assay (ELISA) the level of MMP -9 in plasma and ammio fluid and IL -6 in amnio fluid of pregnant woman with PROM and normal pregnant woman. Further more , study the relationship between the MMP - 9 and IL - 6, I expected by this study I can find the cause and pathogenic mechinism and find a new way to preclude PROM.Materials and MethodsForty pregrant women in which twenty - six case is PROM, average gestational age is (38. 95±1.46 ) weeks (from 34+3week to 41week ) , average (27. 69 ±2. 62) years old (between 23 and 34 years old ). Select at 2:1 ramdom 14 normal pregnant women as control, average gestational age is ( 38. 96±1. 53) week ( from 35+1 to 41 week) , average (27. 7 ± 2. 84) years old (between 24 and 33years) ; All case didnt using antibitotic before take amino fluid . Body tempreture is below 37.5℃. Heart rate of pregnant woman is below 100 per minute . white blood count is below 15000/mm . All cases haven' t regular uterus contraction. Two group have no maternal disease, obsctrical diseases and the abnormal of fetus and fetal position . Tow group of pregnant women have no significant difference in age and gestational week. Collect plasma sample from pregnant woman; We saved 2 ml blood in EDTA (1. 5mg/ml) tube from elbow veins of all pregnant woman, centrifuged it at 1000rpm for 15 minutes, Stored it at - 20#℃ to be used for measurement. We save 3 ml AF when cesarean, centrifuged it at 3000 rpm for 10 minute , and stored it at -70℃ for measurement . We save a piece of membrane (2cm x2cm) immediately after labor of pregnant woman with PROM, set it at least 2 hours , HE stain. We used an enzyme - linked immu-nosorbent assay ( ELISA) to quantitate total matrix metalloproteinase - 9 levels and interleukin - 6 levels in the plasma and AF samples. The quantikine of human MMP - 9 and IL - 6 is provoided by Jingmei and Senxiong companies. All documents are managed by SPSS system, using Mann Whitney Test and Spearsmans rank correlation analysis .ResultPlasma and AF matrix metalloproteinase - 9 level of the pregnant women with PROM are 4222. 7 (429. 37 ~ 10061) pg/ml and 187. 2(38. 95 ~ 867. 54) pg/ml. They compared with noirnal pregnant woman are significantly different ( p < 0. 01 ) . The AF level of IL - 6 in pregnant woman with PROM and the normal group is 10. 399(2. 384 ~ 220. 93 ) pg /ml and 4. 9798 ( 1. 3761 ~ 10. 7563 ) pg/ml. The difference is significant. The MMP - 9 level in plasma and AF is increased significantly if prolong the time of the rupture of membrane. The IL -6 is also . The level of MMP -9 in plasma didnt differ significantly between patient with chorioamnionitis and without chorioam-nianitis ( p > 0. 05 ) . But the levels of MMP - 9 and IL - 6 in AF differ significantly between patient with chorioamnionitis and without chorioamnionitis. The levels of MMP - 9 and IL - 6 in AF of pregnant woman with PROM have significant positive relationship . rs =0.748(P<0.01)DiscussionHuman s fetal membranes are consist of amnio... |
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