Expression Of Matrix Metalloproteinase-9 In Serum Of Early Pregnancy And Placenta Of Preeclampsia

Objective:In this study,the expression level of matrix metalloproteinase-9（MMP-9）in serum of patients with preeclampsia at 6 to 13⁺⁶weeks of gestation and in placental tissue at delivery was detected,and the value of MMP-9 in predicting preeclampsia was analyzed.Methods:From August 1,2019 to June 30,2020,A total of 1476 pregnant women with early pregnancy(6 to 13⁺⁶weeks)who underwent initial obstetric examination in the obstetric outpatient department of the Second Affiliated Hospital of Hainan Medical University were selected as the research subjects.Venous blood samples were collected for preservation.Tracking the pregnancy outcomes.According to the inclusion criteria and exclusion criteria,52 cases of preeclampsia parturients were selected as the experimental group,and 52 cases of normal pregnancy and delivery parturients during the same period were randomly selected as the control group.The expression level of MMP-9 in serum of the two groups during early pregnancy was detected by ELISA;The predictive value of serum MMP-9 in preeclampsia was evaluated by ROC curve;Immunohistochemical method was used to detect the expression level of MMP-9 in the placental tissues of the two groups.Results:（1）In the serum samples of early pregnancy,the expression level of MMP-9 in the experimental group and the control group was 1.69±0.81pg/ml and 2.85±1.67pg/ml.The expression level of MMP-9 in the experimental group was lower than that in the normal pregnancy group,there was a statistically significant（<0.05）.（2）In the placental tissue of delivery,the H-score of MMP-9 in the experimental group and the control group was 29.12±7.82 and 38.80±14.25.The H-score of MMP-9 in the experimental group was lower than that in the normal pregnancy group,there was a statistically significant（<0.05）.（3）The ROC curve was established between the preeclampsia group and the normal control group.The results showed that the area under the curve（AUC）was0.717(95%CI:0.618-0.815,（<0.05）,the maximum approximate index was 0.423,the critical threshold（cut-off value）of MMP-9 expression level in serum of preeclampsia early pregnancy was 2.29pg/ml,the sensitivity was 53.8%,and the specificity was 88.5%.Conclusion:（1）The decreased expression of MMP-9 in serum of early pregnancy of preeclampsia may be involved in the reshaping of uterine spiral artery,which is expected to be a serum biochemical indicator for early prediction of preeclampsia.（2）The decreased expression of MMP-9 in placental tissues during preeclampsia delivery may be related to the damage of trophoblast cells leading to shallow placental implantation,and may be involved in the pathogenesis of preeclampsia.