产妇子宫平滑肌组织中MAPK信号转导通路及CX43表达与产后出血关系的分析-妇产科学(围产医学)专业论文.docxVIP

PAGE PAGE 10 Expression and significance of mitogen-activated protein kinase pathway and connexin43 in myometrium of parturient women in postpartum hemorrhage Abstract Objective To investigate the contractility and contract potentiality of myometrium from postpartum hemorrhage parturient caused by uterine atony， study the expression and alteration of extracellular-signal regulated kinase1(ERKl/2)and c-jun N-terminal kinase(JNKl/2) and p38 in myometrium from them, research the variation of Connexin43(CX43) mRNA and the protein levels, discuss the change of contractility and potentiality of myometrium from postpartum hemorrhage parturient caused by uterine atony ,and to determin the significance of mitogen-activated protein kinase(MAPK) pathway and CX43 in the pathogenesis of postpartum hemorrhage（PPH）,analyze the relationship between MAPK activation and CX43 levels. Methods Isometric tension recording was used for 30 uterus smooth muscle samples in PPH patients of atony (cases: ruled out the PPH patients possibility occurs of retained placental fragments, genital tract trauma and coagulopathy)and 30 normal parturitions (controls:the period parturient without PPH)to detect the contractility and its potentiality induced by oxytocin. The levels of CX43,phosphorylation of ERK1,JNK1and p38MAPK in myometrium of cases and controls were determined by western blotting. ALL of tissues of cases and their controls were detected for the mRNA of CX43 by Real-time fluorescent quantitative reverse transcription PCR. Result The contractility of myometriums in the case group were significanctly lower than that of their controls(P＜0.05),the differences were mainly caused by the frequency of constriction(P＜0.05). To evaluate the postpartum hemorrhage of uterine atony by the diagnosis which constriction acitivity was 72.66 g·times an hour,the area under curve of ROC is 0.802,the insensitivity is 0.867 and the specificity was 0.700. The frequency and range of the constriction induced