脐血促肾上腺皮质激素释放激素、皮质醇、硫酸脱氢表雄酮在早产中的作用

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。方法选择早产产妇26例作为研究组、足月临产产妇29例及足月未临产产妇25例作为对照组，用放射免疫法测定三组产妇分娩新生儿脐静脉血CRH，脐动脉血DHEA—S、皮质醇的含量。结果早产组和足月临产组脐静脉血CRH水平与脐动脉血DHEA—S水平均高于足月未临产组（P〈0．05），而早产组和足月临产组之间无显著性差异（P〉0．05）。早产组脐动脉血皮质醇水平明显高于足月临产组（P〈0．05）和足月未临产组（P〈0．01），足月临产组明显高于足月未临产组（P〈0．05）；早产组中脐血CRH与皮质醇（r1=0．523，P〈0．05）及DHEA—S（r2=0．424，P〈0．05）水平均呈正相关。结论胎盘CRH与胎儿来源的皮质醇、DHEA—S参与了早产的发动，且CRH与皮质醇、DHEA—S在早产的发动过程中均起协同作用。

Effect of CRH,Cortisol and DHEA- S in Fetal Umbilical Cord Blood on Preterm Delivery

Objective To investigation the effect of corticotropin - releasing hormone, cortisol and dehydroepiandrosterone sulfate in pathogenesis of preterm delivery. Methods A cross - sectional study was conducted with 80 pregnant in the following categories： preterm delivery in labor（PL, n = 26）, term in labor（TL, n = 29） and term not in labor（n = 25）. Radioimmunoassay was used to detect the levels of corticotropin releasing hormone, cortisol and dehydroepiandrosterone sulfate in fetal umbilical cord blood in three group. Results The levels of CRH and DHEA - S in umbilical cord bloods of PLand TLare higher than that in term not in labor（ P 〈 0.05）. And there is no difference between PL and TL（ P 〉 0.05）.The levels of cortisol in umbilical cord bloods of PL are higher than that in TL and term not in labor. And the levels of cortisol in umbilical cord bloods of TL are higher than that in term not in labor（ P 〈 0.05）. In PL, the levels of CRH and cortisol or dehydroepiandrosterone sulfate in umbilical cord bloods are correlated respectively with each other（r1 = 0. 523, r2 = 0.424, P 〈 0.05）. Conclusion CRH , Cortisol and dehydroepiandrosterone sulfate play an important role in the pathogenesis of preterm delivery. CRH and cortisol or dehydroepiandrosterone sulfate may contribute to each other in the mechanism of preterm delivery.