促肾上腺皮质激素释放激素、皮质醇及硫酸脱氢表雄酮与分娩发动关系的研究

目的 :测定足月妊娠妇女在分娩发动前后外周血及脐静脉血中促肾上腺皮质激素释放激素 (CRH)、皮质醇 (CORT)、硫酸脱氢表雄酮 (DHEAs)水平 ,以探讨CRH、CORT及DHEAs在足月分娩发动中的作用。方法 :测定 4 0例自然分娩发动孕妇及 4 0例同孕周的选择性剖宫产孕妇外周血、脐静脉血CRH、CORT及DHEAs水平。CRH的测定用放射免疫法 ,CORT用 2 0 0 0型全自动化学发光检测系统 ,DHEAs用酶联免疫法。结果 :(1)自然分娩发动组潜伏期及活跃期血CRH水平均显著高于选择性剖宫产组 (P <0 .0 5 ) ,而潜伏期及活跃期CRH水平无统计学差异 (P >0 .0 5 ) ;自然分娩发动组潜伏期、活跃期及选择性剖宫产组之间的血DHEAs水平无统计学差异 (P >0 .0 5 ) ;自然分娩发动组潜伏期、活跃期的血CORT水平与剖宫产组相比有升高的趋势 ,但 3者间差异无显著性 (P >0 .0 5 ) ;(2 )自然分娩发动组脐血CRH、CORT、DHEAs水平均显著高于选择性剖宫产组 (P <0 .0 5 ,P <0 .0 1,P <0 .0 5 ) ,且CORT、DHEAs与CRH水平均呈正相关 (r1=0 .74 ,P <0 .0 5 ;r2 =0 .91,P <0 .0 1) ;两组新生儿的平均体重差异无显著性 (P >0 .0 5 )。结论 :胎盘CRH与胎儿来源的CORT、DHEAs ,可能在足月分娩发动中起重要作用

The relationship between corticotropin-releasing hormone, cortisol, dehydroepiandrosterone sulfate and term parturition

Objective:To investigate the relationship between corticotropin-releasing hormone (CRH),cortisol (CORT),dehydroepiandrosterone sulfate(DHEAs) and term parturition by determining maternal and cord blood CRH,CORT and DHEAs levels before and after term onset.Methods:Maternal and cord blood samples were taken from 40 women who entered spontaneous labor and 40 women who delivered by selective cesarean section.Plasma CRH levels were determined by radioimmunoassay.Serum CORT levels were measured by immulite 2000-automated continuous random access chemiluminescent immunoassay system,and serum DHEAs levels were tested by enzyme-linked immunosorbant assay.Results:(1) There was no significant difference between maternal plasma CRH levels in latent labor and those in active labor (P>0.05). Plasma CRH levels in wom-en delivered by selective cesarean section were lower than those in latent labor or active labor (P< 0.05). There was no differences between plasma CORT,DHEAs levels in women who entered spontaneous labor and in those who delivered by selective cesarean section (P>0.05).(2)There was significant difference between cord blood CRH,CORT,DHEAs levels in women who entered spontaneous labor and those in women who delivered by selective cesarean section (P<0.05,P<0.01,P<0.05).Cord serum DHEAs and CORT levels were significantly correlated with cord plasma CRH levels,respectively (r 1=0.74,P<0.05; r 2=0.91,P<0.01).Conclusion:The placental CRH and fetal CORT,DHEAs may play important roles in the onset of term labor.