血清松弛素与孕产妇盆底功能变化的关系  

The relationship between serum concentration of relaxin and the pelvic floor function

作　　者：郑颖[1,2] 李瑞满[1] 帅翰林[1] 王晓玉[1] 罗新[1] 

机构地区：[1]暨南大学附属第一医院妇科,广州510630 [2]重庆市第九人民医院妇产科

出　　处：《中国妇产科临床杂志》2011年第2期96-99,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：广东省医学科研基金立项资助课题(A2007338和A2008364);广东省科技计划(2007B060401054)项目;国家自然科学基金面(81070459)项目资助

摘　　要：目的测定妊娠和产后不同时期的血清松弛素(relaxin,RLX)水平,以探讨孕产妇孕期和产后盆底功能变化的机制。方法选取健康孕产妇36例分别于孕晚期、产后6～8周、产后3～6个月测定其盆底肌肉综合肌力作为研究组,无分娩史、无盆底功能障碍性疾病(PFD)史的非妊娠女性20例作为对照组;应用酶联免疫吸附法检测不同时期的血清RLX水平;并行自制PFD问卷调查。结果妊娠晚期RLX水平明显高于产后两组及对照组(P<0.001),产后两组与对照组的血清RLX水平比较,差异无统计学意义(P=0.913);孕晚期血清RLX水平与孕晚期和产后盆底肌综合肌力呈负相关(r=-0.354、-0.415,P<0.05);孕晚期和产后两组有SUI症状者的RLX[(462.17±27.45)pg/ml、(466.00±24.91)、(458.00±27.80)pg/ml]水平高于无症状者[(427.00±31.51)pg/ml、(429.63±32.30)pg/ml、(433.20±33.05)pg/ml;P<0.05];孕晚期和产后两组的腰骶部酸痛者孕期血清RLX[(449.76±32.13)pg/ml、(450.48±32.55)pg/ml、(442.12±31.95)pg/ml]水平明显增高(P<0.05);产后6～8周和3～6个月阴道松弛者孕晚期血清RLX[(446.71±26.96)pg/ml;444.38±36.90)pg/ml]水平均较高。结论妊娠期出现盆底功能改变与体内激素的变化有关;孕期高水平的血清RLX可作用于盆底胶原组织,可能是孕期和产后PFD的病理机制之一。Objective To detect the mechanisms of change of pelvic floor function and the etiopathogenisis of pelvic floor dysfunction（PFD）.MethodsPelvic floor muscle strength was measured in 36 women in late pregnancy（group 1）,6 to 8 weeks after labour（group 2）and 3 to 6 months after labour（group 3）.20 nulliparous and nonfertile women acted as control（control group）.Serum concentration of relaxin（RLX）in each group were detected by enzymelinked immunosorbent assay;and pelvic floor dysfunction questionnaire were fulfilled.ResultsConcentration of serum RLX in group 1 was significantly higher than that in group 2,group3 and control group（F=2 072.79,P0.001）,and there were no significant difference between group 2,3 and control（F=0.092,P=0.913）;the level of RLX in antepartum and early postpartum were negatively correlated with postpartum pelvic floor muscle strength（r=-0.354、-0.415,P0.05）.There were significant impact of the concentrations of antepartum serum RLX on the symptom of SUI before delivery and early postpartum and the symptom of ache at waist and sacrum before delivery and early postpartum.ConclusionsThe high level serum of RLX during pregnancy affects the change of pelvic floor collagen,which may be one of the pathomechanisms of PFD.

关 键 词：盆底 肌力 盆底功能障碍性疾病 血清松弛素 

分 类 号：R714.2[医药卫生—妇产科学]