目的 研究基质金属蛋白酶9(MMPs-9)和基质金属蛋白酶组织抑制剂1,2(TIMP-1,2)在子宫剖宫产疤痕愈合中的影响.方法 收集2009年8月～2011年11月在我院收治的有严重并发症的疤痕子宫妊娠病人22例(子宫剖宫产疤痕早期8例妊娠(CSP)、因胎盘粘连或植入而行子宫切除术的疤痕子宫足月妊娠病例14例)；选择同期孕期检查正常无并发症疤痕子宫足月妊娠病人38例作为对照1组；同期孕期检查正常、无任何并发症因社会因素要求剖宫产的足月妊娠病人32例作为对照2组.采用免疫组织化学EnVision二步法检测3组中MMPs-9和TIMP-1,2的表达,并对其表达进行相关性分析.结果 MMPs-9、TIMP-1在3组间的表达差异有统计学意义(P＜0.05).TIMP-2在3组间的表达差异无统计学意义(P＞0.05).Spearman等级相关分析显示,在疤痕组织中MMPs-9的表达随疤痕愈合不良呈正相关,相关系数分别是0.309、0.643.随着疤痕愈合不良程度加重,MMPs-9的表达逐渐增强,差异有统计学意义(P＜0.05).结论 子宫疤痕愈合不良、CSP可能和损伤修复中MMPs-9、TIMP-1的表达失衡有关.%Objective To investigate the roles of MMPs-9, TIMP-1 and TIMP-2 in cesarean section scar healing. Methods The expressions of the MMPs-9, TIMP-1 and TIMP-2 were detected by EnVision immunohistochemistry in 22 pregnant women with serious complications of the uterine scar, including 8 with early caesarean scar pregnancy (CSP) and 14 with full-term pregnancy undergoing hysterectomy for placenta previa or implanted placenta. Thirty-eight full-term pregnant women without serious complications of the uterine scar and 32 normal full-term pregnant women served as the control I and control II groups, respectively. Results The expressions of MMPs-9 and TIMP-1 differed significantly between the 3 groups (P<0.05), whereas TIMP-2 did not (P>0.05). Spearman rank correlation analysis showed that the expression of MMPs-9 in the uterine scar tissues was positively correlated with poor uterine scar healing with the correlation coefficients of 0.309 and 0.643. An increased severity of poor healing scar was associated with a significantly increased expression of MMPs-9 (P<0.05). Conclusion The imbalanced expressions of MMPs-9 and TIMP-1 in injury repair can be related to poor uterine scar healing and CSP.
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