MIF和iNOS在胎膜早破产妇胎膜组织中的表达及意义

摘要

目的：探讨巨噬细胞移动抑制因子（ MIF）与诱导型一氧化氮合酶（ iNOS）在胎膜早破（ PROM）发生、发展中的作用。方法研究对象为90例剖宫产的产妇；其中早产胎膜早破（pPROM）30例（pPROM组），足月胎膜早破（ tPROM）30例（ tPROM组），正常足月妊娠30例（正常组）。三组均于剖宫产术中胎盘娩出后于距离胎膜破口＞2 cm处取1 cm ×1 cm的胎膜组织制作切片。采用HE染色方法检测绒毛膜羊膜炎（中性粒细胞中、重度浸润）发生情况；采用免疫组化SP法检测MIF、iNOS表达；分析三组及绒毛膜羊膜炎、非绒毛膜羊膜炎产妇MIF、iNOS表达情况。结果三组共检出绒毛膜羊膜炎27例；MIF 和 iNOS 主要表达于羊膜上皮细胞的胞质。 pPROM 组和tPROM组MIF表达强度明显高于对照组（P＜0．01）；pPROM组iNOS表达强度明显高于对照组（P＜0．01）；绒毛膜羊膜炎产妇胎膜中MIF和iNOS表达强度明显高于非绒毛膜羊膜炎产妇（P＜0．05）。结论 PROM产妇胎膜组织中MIF、iNOS表达上调。 MIF、iNOS高表达可促进胎膜早破及绒毛膜羊膜炎的发生。%Objective To study the effect of macrophage migration inhibition factor( MIF) and inducible nitric oxide synthase (iNOS) in the development of premature rupture of fetal membranes(PROM).Methods A total of 90 parturient women who had delivered by cesarean section before labor were selected in the study and were divided into 3 groups, which were preterm premature rupture of the membranes group ( pPROM group, 30 cases) , term premature rupture of the mem-branes group(tPROM group, 30 cases) and full-term cesarean section delivery group (control group, 30 cases).The membranes were collected from the >2 cm point of rupture of membranes about 1 cm ×1 cm in cesarean section after preg-nancy termination with placenta deliveried and made into paraffin sections.Chorioamnionitis was identified by using HE staining to determine the neutrophilic granulocyte infiltration.The distributions and expression levels of MIF and iNOS in fetal membranes were detected by immuno histochemical method.The expression of MIF and iNOS in the three groups were analyzed.Results A total of 27 cases chorioamnionitises were found.MIF and iNOS located in cytoplasm of amnio-endo-thelial cells.The expression of MIF in fetal membrane cells in pPROM group and tPROM group were higher than that in control group(P<0.01).The expression of iNOS in pPROM group was higher than that in control group (P<0.01).The expression levels of MIF and iNOS in chorioamnionitis puerperas were significantly higher than those in non-chorioamnionitis puerperas(P<0.05).Conclusions The expression of MIF and iNOS increase in fetal membrane of RPOM puerperas. The overexpression of MIF and iNOS may promote the development of PROM and chorioamnionitis.