应激与早产孕妇胎盘促肾上腺皮质激素释放激素信使核糖核酸的表达

Correlative study between stress and preterm birth expression corticotropin releasing hormone mRNA in women with preterm birth

目的:探讨应激及其应对方式与早产和胎盘促肾上腺皮质激素释放激素(corticotropin releasing hormone,CRH)信使核糖核酸(mRNA)水平的相关性. 方法:研究对象来自2003年6月至2005年3月在镇江第四人民医院产科分娩的单胎初产妇,早产组46例,正常产组42例;采用生活事件量表(LES)及防御方式问卷(DSQ)在第28周时进行自我评定,胎盘组织的CRH-mRNA的表达采用RT-PCR方法测定,以光密度值(OD值)作为观察数据.统计方法采用独立样本t检验和逐步回归分析. 结果:早产组与正常产组在恶性生活事件频度和强度、DSQ的不成熟防御因子(DSQ1)分值的差异有显著性(P<0.05～0.001);早产因子、DSQ1分值与胎盘CRH-mRNA的相对含量(OD值)呈正相关,偏回归系数分别为0.552和0.345,t值分别为5.693和3.618,P值均＜0.001. 结论:心理应激及其应对方式与早产的发生相关 ,胎盘CRH-mRNA的高度表达可能是心理应激与早产发生的病理生理中介机制.

Objective： To explore the correlation of stress, coping style and placental corticotropin releasing hormone（CRH） CRH-mRNA level between preterm birth and normal birth. Method：46 with preterm birth and 42 normal birth controls were assessed with life event scale （LES） and defence style questionnaire （DSQ） at 28th-week of pregnancy.The level of placental CRH-mRNA was detected by RT-PCR. Results： On the scales of malignant life events, immature and middle type defence style scales, and CRH-mRNA. There were significant difference between preterm birth and normal birth controls （P 〈 0.05 -0. 001 ）;The level of CRH-mRNA was positively correlative with preterm birth and the scales of DSQ1 factor, resulting from multiplie regressive analysis （ SB： 0. 552,0. 345 ; t ： 5. 693, 3.618; P 〈 0. 001 ）. Conclusion： The high expression of placental CRH-mRNA may be path-physiological media mechanism between stress and occurrence of preterm birth.