摘要
目的探讨促肾上腺皮质激素释放激素(CRH)、皮质醇、硫酸脱氢表雄酮(DHEA-S)在早产发动中的作用。方法用原位杂交法检测早产阴道分娩产妇26例(早产组)、足月临产阴道分娩产妇29例(足月临产组)、足月未临产剖宫产产妇25例(足月未临产组)胎盘、胎膜组织中 CRHmRNA 的分布与表达,用放射免疫法测定3组产妇分娩的新生儿脐静脉血 CRH,脐动脉血 DHEA-S 及皮质醇的含量。结果 (1)各组产妇胎盘、胎膜组织中均可见 CRH mRNA 表达。(2)CRH mRNA 在胎盘组织中表达的阳性指数:早产组为5.5±1.4,足月临产组为5.4±1.5,均高于足月未临产组的2.7±1.5,差异均有统计学意义(P<0.01);CRH mRNA 在胎膜组织中表达的阳性指数:早产组为5.4±1.7,足月临产组为5.4±1.4,足月未临产组为2.0±1.4,早产组、足月临产组与足月未临产组比较,差异也有统计学意义(P<0.01);CRH mRNA 在胎盘及胎膜中表达的阳性指数早产组与足月临产组比较,差异无统计学意义(P>0.05);各组产妇 CRH mRNA 在胎盘与胎膜组织中的表达比较,差异均无统计学意义(P>0.05)。(3)早产组和足月临产组新生儿脐静脉血 CRH 含量分别为(7.8±3.3)、(7.7±4.1)ng/L,脐动脉血 DHEA-S 含量分别为(514±295)、(483±207)μg/L,均高于足月未临产组的(4.8±2.4)ng/L、(360±80)μg/L,差异有统计学意义(P<0.05);而早产组与足月临产组比较,差异则无统计学意义(P>0.05)。早产组脐静脉血 CRH 含量与胎盘、胎膜组织中 CRHmRNA 的表达均呈正相关关系(r=0.935、0.853,P<0.01),足月临产组脐静脉血 CRH 含量与胎盘、胎膜组织中 CRH mRNA 的表达也呈正相关关系(r=0.902、0.825,P<0.01)。(4)早产组新生儿脐动脉血皮质醇含量为(246±117)μg/L,明显高于足月临产组的(172±72)μg/L 和足月未临产组的(127±60)μg/L,差异均有统计学意义(P<0.05,P<0.01)。早产组新生儿脐静脉血 CRH 与脐动脉血皮质醇、DHEA-S 含量均呈正相关关系(r=0.
Objective To investigate the effect of corticotropin-releasing hormone （ CRH）, cortisol and dehydroepiandrosterone sulfate in pathogenesis of preterm labor. Methods A cross-sectional study was conducted including 80 pregnant women in the following categories： （1）preterm delivery in labor（ PL, n = 26）, （2） term in labor（ TL, n = 29 ）, （3） term not in labor （ n = 25 ）. The expression and localizations of CRH mRNA in placentas and fetal membranes in three groups respectively were examined by in situ hybridization. Radioimmunoassay was used to detect the levels of corticotropin releasing hormone, cortisol and dehydroepiandrosterone sulfate in fetal umbilical cord blood in three groups. Results （ 1 ） By in situ hybridization, we localized CRH mRNA to the syncytiotrophoblasts of placenta, the anmiotic epithelial cells and chorion cells. （ 2 ） The positive index of expression of CRH mRNA in fetal membranes of PL （ 5.4 ± 1.4） and TL, （5.4 ± 1.5 ） was higher than that in term not in labor, （2. 0 ± 1.4, P 〈 0. 01 ）. And there was no difference between PL and TL （ P 〉 0. 05 ）. The positive index of expression of CRH mRNA in placentas of PL（5.5 ± 1.4） and TL（5.4 ± 1.5） was higher than that in term not in labor（2. 7 ± 1.5, P 〈 0. 01 ）. And there was no difference between PL and TL（P 〉0. 05）. The expression of CRH mRNA was not distinct between placentas and fetal membranes in three groups （ P 〉 0. 05 ）. （ 3 ） The levels of CRH and DHEA-S in umbilical cord blood of PL（7. 8 ± 3.3 ）ng/L, and （514 ± 295 ） p,g/L, respectively and of TL （7. 7 ±4. 1 ） ng/L, and （483±207） μg/L, were higher than that in term not in labor（4. 8 ±2. 4） ng/L, and （360 ± 80） μg/L, respectively （ P 〈 0. 05 ）. And there was no difference between PL and TL （ P 〉 0. 05 ）. In PL, the level of CRH in umbilical cord blood and the expression of CRH mRNA in placentas and fetal membranes were correlated with each other（ r = 0.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2007年第4期239-243,共5页
Chinese Journal of Obstetrics and Gynecology
基金
湖南省发展计划委员会科技课题(2003-790-18)
关键词
分娩
早产
促肾上腺皮质素释放激素
氢化可的松
硫酸脱氢表雄酮
原位杂交
Labor, premature
Corticotropin-releasing hormone
Hydrocortisone
Dehydroepiandrosterone sulfate
In situ hybridization
