用血催乳素和雌二醇比值估计产后月经恢复  

Measurement of Prolactin and Estradiol to Estimate Menses Return of Breastfeeding Mothers

作　　者：金碧华[1] 虞荷莲 金敏菲[1] 杜学亮[1] 杨淑蓉[1] 吴靖川[1] 

机构地区：[1]上海第二医科大学新华医院,上海200092

出　　处：《生殖与避孕》2003年第5期275-277,282,共4页Reproduction and Contraception

基　　金：美国家庭基金会基金

摘　　要：目的:测定血催乳素(PRL)和雌二醇(E_2)比值,对估计产后月经恢复的有效性和实用性。方法:采用放射免疫法分别测定产后<2月(134例),2月～(100例),3月～(159例),4月～(118例),5月～(110例),6～9月(82例)妇女的血PRL/E_2。结果:(1)母乳、混合、人工喂养组的PRL/E_2平均值分别为8.16、3.66、0.69,各组间均有统计学差异;(2)PRL/E_2值大小与产后时间无关;(3)妇女月经恢复:产后6月时,55.05％;9月时,97.46％;(4)若以PRL/E_2值=0.6来估计月经恢复,其灵敏度为89.85％,特异性为90.68％。结论:血PRL、E_2测定方法简单、正确、不需昂贵的仪器和设备,可准确估计产后妇女的月经恢复,有利于她们及时采用避孕措施,可推广应用。Objective To determine whether the measurement of serum prolactin (PRL) and estradiol (E_2) is effective and reliable to estimate the returning time of menses during breastfeeding. Methods:Serum PRL and E_2 were measured in 703 hreastfeeding mothers during the period of <2, > 3, 4, 5 and 6～9 months postpartum. Radio-immunoassay (RIA) was used to measure the levels of PRL and E_2. The cervical mucus, sexual behaviors and vagina bleeding were also monitored since 56 d after postpantum. Results : (1) The average level of serum PRL and E_2 was 8.16, 3.66, 0.69 in the fully breastfeeding, mixed-feeding and bottle-feeding groups respectively. It showed that 92.55% mother returned menses within 6 months of postpartum in the bottle-feeding group. (2) According to the results, the levels of serum Prolactin and Estradiol were related to the feeding ways, but not completely related to the duration of postpartum. (3) By using the ratio of PRL to E_2 to estimate the time of menses return among the breastfeeding mothers, we found that when the ratio became 0.60, the subjects' menses would returen. The sensitivity and the specificity of this method were 89.85% and 90.68% respectively. Conclusion :The measurement of serum PRL and E_2 is a simple, effective and reliable method to estimate the return time of menses during breastfeeding period. If possible, it should be promoted for clinical use to prepare for their fertility return.

关 键 词：血生乳素(PRL) 雌二醇(E2) 月经恢复 产后 

分 类 号：R714.6[医药卫生—妇产科学]