地塞米松、黄体酮对未足月胎膜早破患者CRH及分娩时间影响的研究  

Effects of dexamethasone on the levels of corticotropin-releasing hormone and the time of delivery in patients with premature rupture of membrane.

作　　者：罗霞[1] 周仲元[1] 王谦[2] 

机构地区：[1]山东大学齐鲁医院妇产科,济南250012 [2]山东大学齐鲁医院检验科,济南250012

出　　处：《现代妇产科进展》2008年第9期669-671,共3页Progress in Obstetrics and Gynecology

摘　　要：目的：研究地塞米松（DEX）、黄体酮（P）对未足月胎膜早破患者外周血促肾上腺皮质激素释放激素（CRH）及分娩时间的影响，探讨用于促胎肺成熟时可能存在的促分娩发动作用及拮抗作用。方法：选取57例妊娠34～36周发生胎膜旱破的孕妇，随机分为4组，DEX组14例，肌肉注射地塞米松5mg，1次／12h，连用2天；DEX＋P组14例，肌肉注射地塞米松同时给予黄体酮20mg，1次／d，连用2天；P组13例，肌肉注射黄体酮20mg，1次／d，连用2天；对照组16例，未给予地塞米松和黄体酮的胎膜早破孕妇。分别于入院时、入院后24h、48h测定4组孕妇外周血CRH含量及入院至胎儿娩出的时间。用放射免疫法测定CRH含量，同时定期监测研究对象的体温、脉搏、外周血白细胞及C反应蛋白。结果：（1）所有研究对象观察期间体温、脉搏、白细胞和C反应蛋白均在正常范围，各组间无统计学差异（P〉0．05）；（2）4组孕妇入院时外周血CRH无统计学差异（P〉0．05），入院24h及48h DEX组CRH水平高于DEX＋P组、P组及对照组，差异有统计学意义（P〈0．05，P〈0．01）；后3组之间无统计学差异（均P〉0．05）；（3）4组孕妇均经阴分娩。DEX组的分娩时间显著短于DEX＋P组（P〈0．05）、P组（P〈0．01）及对照组（P〈0．01）；（4）CRH水平与分娩时间呈负相关（r=-0．79，P〈0．05）；（5）4组研究对象的新生儿评分和体重均无统计学差异（P〉0．05）。结论：地塞米松可能通过上调促肾上腺皮质激素释放激素发挥促分娩发动作用，黄体酮可对抗地塞米松的促分娩发动作用。Objective：To investigate the role of dexamethasone （DEX） in labor onset when used in patients with premature rupture of membrane to ripen fetal lung,and the anti-dexamethasone role of progesterone（P） ,by studying the effects of DEX and P on the level of CRH and the time of delivery in patients with premature rupture of membrane. Methods：Fifty seven cases women at 34 - 36 weeks gestation with premature rupture of membrane were investigated, which included 14 cases administrated DEX 5mg q12 × 2d（DEX group）, 14 cases administrated DEX 5mg q12h × 2d and P 20mg, qd × 2d（ DEX ＋ P group） , 13 cases administrated P 20mg qd × 2d （P group）, 16 cases as normal controls. Maternal plasma concentrations of CRH were measured at the time of hospitalization and 24 hours, 48 hours after hospitalization. The time from membrane rupture to delivery was calculated. CRH levels were measured by radioimmunoassay. The temperature, pulse, white blood cell counts and C reaction protein of all pregnant women were measured. Results： （ 1 ） The temperature, pulse, white blood cell counts and C reaction protein of all pregnant women were in normal score, there were no significantly statistical differences among four groups;（2）There were no significantly statistical differences in the levels of CRH among the four groups at the time of hospitalization（ P 〉0.05 ）. 24 hours ,48 hours after hospitalization, maternal plasma CRH levels in DEX group was significantly higher than those in DEX ＋ P group,P group and normal controls（P 〈0.05 ,P 〈0.01 ）. There was no significantly statistical difference in the levels of CRH between DEX ＋ P group, P group and normal controls （ P 〉 0.05 ） ; （ 3 ） was significantly shorter than mal controls （ P 〈 0.01 ） ; （ 4 All patients were delivered vaginall that in DEX ＋ P group （ P 〈 0.05 ） ） There was a negative correlation y. The time cost in DEX group ,P group（P 〈0. Ol ）and nor- between the concentrations of CRH and the time of

关 键 词：黄体酮 促肾上腺皮质素释放激素 地塞米松 未足月胎膜早破 分娩发作 

分 类 号：R737.33[医药卫生—肿瘤]