Study On The Relationship Between PON1,CYP1A1 And MMPs And Premature Rupture Of Preterm Membranes

Objective:To investigate the correlation between paraoxonase-1(PON1),cytochrome P4501A1 enzyme(CYP1A1),matrix metalloproteinase-1(MMP-1),matrix metalloproteinase-8(MMP-8)and preterm premature rupture of membranes(PPROM).Methods:Retrospective analysis patients from 42 cases of preterm premature rupture of membranes admitted in the neonatal department of our hospital from January 2018 to December 2019.At the same time period,46 pregnant women with the without premature rupture of membrane group admitted in obstetrics department of our hospital were selected as the control group.In addition,50 pregnant women without premature rupture of membrane group admitted in our hospital were selected as the normal control group.Compare the clinical data of pregnant women in each group and analyze the major high-risk clinical of premature rupture of membranes through multi-factor Logistic analysis.Determination of PON 1 and CYP1A1 levels in cord blood serum by ELISA.Observe the histological changes of placenta by HE staining.Use Western blot to detect the expression level of MMP-1 and MMP-8 in placenta tissue.Results:1.There was no correlation between sex,age of pregnant women,pregnancy times and premature rupture of membranes(P>0.05);There is a significant correlation between upper respiratory tract infection and birth protection during pregnancy and premature rupture of membrane(OR=2.696,P<0.05).2.Compared with the without premature rupture of membrane group,the level of PON 1 in the term premature rupture of membrane group and the preterm premature rupture of membrane group was low.Moreover the level of PON 1 in the preterm premature rupture of membrane(PPROM)group was lower than that of the term premature rupture of membrane group and the difference was statistically significant(P<0.05).The level of CYP1A1 in the preterm premature rupture of membrane group and the term premature rupture of membrane group was significantly higher than that of normal term group(P<0.05).3.HE staining of placenta and fetal membrane found:the preterm premature rupture of membrane group 13 cases of chorioamnionitis occurred,and the incidence rate was 30.9%.It was higher than the term premature rupture membrane group(4 cases,8.7%)and without premature rupture of membrane group(3 cases,6.0%).Acute chorioamnionitis mainly manifests as neutrophil infiltration in the amniotic membrane or chorionic plate.Chronic chorioamnionitis manifests as infiltration of lymphocytes in the chorionic amniotic membrane.4.Compared with the without premature rupture of membrane group,the levels of MMP-1 and MMP-8 in the preterm premature rupture of membrane group and the term premature rupture of membrane group were higher than those in the without premature rupture of membrane group,The levels of MMP-1 and MMP-8 in the preterm premature rupture of membrane group were higher than term premature rupture of membrane group(P<0.05).Conclusions:1.The upper respiratory tract infection and the history of birth protection during pregnancy are the clinical risk factors of premature rupture of membranes,and the infection of upper respiratory tract is the most important risk factor.2.The level of PON 1 and CYP1A1 in cord blood is related to the preterm premature rupture of membrane group,suggesting that oxidative stress is involved in rupture of fetal membrane.3.Intrauterine infection and(or)inflammation is one of the important causes of the preterm premature rupture of membrane.4.The increased expression of MMP-1 and MMP-8 in placental tissue is related to the preterm premature rupture of membrane.