精神心理状态影响分娩发动的分子机制研究  

Molecular mechanism underlying effects of psychic state on the onset of parturition

作　　者：张葳[1] 屈新中[2] 张璐[3] 雷新军[4] 

机构地区：[1]西安交通大学医学院第一附属医院儿科,陕西西安710061 [2]西安交通大学医学院第一附属医院妇产科,陕西西安710061 [3]北京石景山医院妇产科,北京100043 [4]西安交通大学医学院第一附属医院心脏内科,陕西西安710061

出　　处：《第四军医大学学报》2007年第21期1990-1992,共3页Journal of the Fourth Military Medical University

基　　金：陕西省科技攻关项目(2005K15-G)

摘　　要：目的:研究单胎初产妇的精神心理状态及其参与分娩发动的分子机制.方法:将妊娠末期住院待产的单胎初产妇分为临产组(已进入产程,有规律宫缩)30例和未临产组(未进入产程)30例,入院当天即采用SCL-90及HAMA焦虑量表对其进行精神心理行为评估;第2日8:00am(产程1期)和术后24h(产程3期)采血3mL和剖宫产术中取子宫下段肌组织50mg,分别用放射免疫学方法测定血浆促肾上腺皮质激素释放激素(CRH)水平和子宫肌环磷酸腺苷(cAMP)含量.结果:妊娠末期,单胎初产妇的精神心理行为指标在临产组和未临产组之间没有统计学差异(P>0.05),而血浆CRH水平均较基础状态明显升高,分别为(232±42)μg/L和(222±54)μg/L(P<0.05).恐怖情绪与妊娠末期血浆CRH水平显著相关(r=-0.412,P=0.026).子宫肌中cAMP含量在临产组明显低于未临产组[(50±15)pmol/gvs(67±13)pmol/g,P<0.01],但两组均与各种精神心理行为指标之间没有相关性(P>0.05).结论:恐怖情绪可能通过增加孕妇胎盘CRH的分泌水平而参与分娩发动,与cAMP介导的子宫肌静止状态结束无关.AIM： To investigate the psychic state of primipara with single birth and the molecular mechanism underlying its effects on the onset of parturition. METHODS： All primipara with single birth were divided into the labor group （ n = 30） and non-labor group （n = 30）, whose psychic state was evaluated with SCL-90 and HAMA on the day of hospital admission and the blood samples （3 mL） were harvested at the next 8：00 am and 24 h after operation respectively. The uterine muscular tissues （50 mg） were obtained during caesarean section. The level of plasma corticotrophin releasing hormone （CRH） and the content of uterine cyclic adenosine monophosphate （cAMP） were deter- mined by radioimmunologic method. RESULTS： There was no significant difference in the psychic state between the puerpera in labor group and non-labor group in the final gestational period （P 〉 0. 05 ）, but the plasma CRH level significantly elevated [ （232 ± 42） μg/L and （ 222 ± 54） μg/L, P 〈 0.05 respectively] compared with the fundamental level. The fear feeling of puer- pera was significantly related to the level of plasma CRH in the fi- nal gestational period （r = -0.412, P = 0.026）. The content of uterine cAMP in labor group was lower than that in non-labor group [ （50 ± 15） pmol/g vs （67 ± 13） pmol/g, P 〈0.01 ]. However, there was no any relationship between the psychic state in puerperal with the content of uterine cAMP （ P 〉 0. 05 ）. CONCLUSION： The fear feeling may participate in the onset of oarturition by elevating the level of CRH in placenta, but has noany relationship with the termination of uterine quiescent condition.

关 键 词：精神因素 心理因素 分娩发动 促肾上腺皮质激素释放激素 环磷酸腺苷 

分 类 号：R714.3[医药卫生—妇产科学]