基质金属蛋白酶组织抑制剂1与宫颈成熟和扩张关系的研究-妇产科学专业论文.docxVIP

AbstractObjective Abstract Objective To study the relationship between Tissue Inhibitor of MetalloDroteinase一1(TIMP一1) and the maturation and ripening of the cervix，which can provide US the theorical basiS on studying the mechanism of labor． Methods We measured the concentrat ions of TIMP一1 i n both 56 caseS with uteral contraction and 16 cases Without，after their cesarean sections，by ELISA．Then we divided the former into 4 groups：16 cases with ripening of the cervixes less than 3cm，14 cases from 3cm to 5am，14 cases more than 5cm and the other 12 cases having entered the second stage of labor． Results We found a significant difference between the group with contraction and the without(PO．05)：Within the uteri having entered the first stage of labor，the bigger the cervix had ripened，the higher concentration of TIMP一1 we gained，but there was no significant difference among them(PO．05)：the uteri having entered the second stage of labor had higher concentration of．TIMP一1 than those in first stage and those without contraction(PO．05)．Conclusion The concentration of TIMP一1 in the cervix increased accompanied with the ripening of cervix．We can draw the conclusion that the rise——up of TIMP—’1 in local cervix iS Significantly related to the maturation and the ripening of the cerviX． Key word Tissue Inhibitor of Metal loproteinase一1；the maturation and ripening of the cervix；the low uterine segment 2 英文缩略语 英文缩略语 MMP基质金属蛋白酶 TIMP基质金属蛋白酶组织抑制剂 ECM细胞外基质 前言 前言 分娩开始于规律宫缩及宫颈成熟和扩张，宫口扩张至开全是 阴式分娩的必要条件，近来通过组织化学检查、动物实验及临床 观察发现宫颈扩张不仅作为子宫收缩的结果而发生，也是宫颈自 身的主动变化 。目前认为宫颈在妊娠不同时期及产后，在内分 泌、激素及细胞因子的调控下，其形态学、组织学和物理特性均 发生显著变化，尤其在妊娠后期特别显著“1。 宫颈主要由结缔组织组成，还有少量的平滑肌及血管。胶原 提供了宫颈组织的硬度，占宫颈结缔组织的70％，主要由I型胶 原组成。分娩时宫颈成熟和扩张与胶原的降解密切相关，随妊娠 的进展宫颈胶原纤维被分解而明显减少。妊娠中期以后，胶原纤 维含量逐渐减少，纤维断裂，排列松散成网状。分娩期妇女宫颈 组织中的胶原合成和分解都增加，分解大于合成。胶原分解过程 主要由基质金属蛋白酶(Matrix Metal loproteinases，MMPs)介 导‘“，它是一种Zn”依赖的内肽酶，对细胞外基质(Extracellular Matrix，ECM)有广泛的降解作用，其中MMP一1、MMP一8和MMP一9在 分娩中作用较大，但是MMPs的活性受基质金