内皮素对妊娠与分娩的影响

EFFECT OF ENDOTHELIN ON PREGNANCY AND LABOR

用放射免疫法测定81例妇女血浆及羊水内反素-1(ET-1)和前列腺素E_2(PGF_2)的含量,其中第二产程妇女20例、潜伏期14例、正常晚孕15例、期妊娠10例、产后期12例.正常非孕10例为对照组.结果第二产程、潜伏期、正常晓孕期、中期妊娠组血浆ET-1含量均显著高于非孕及产后期妇女,且随妊娠及产程的进展而逐渐增高,至第二产程达高峰,产后迅速降至非孕时水平.各孕产期羊水ET-1及PGE_2的含量显著高于血浆ET-1及PGE_2的含量.血浆及羊水PGE_2浓度随ET-1含量的增减而变化,两者呈显著正相关.提示血浆及羊水ET-1水平随妊娠的进展而增加,促使足月妊娠子宫产生收缩,ET-1还可通过刺激前列腺素E_2的生成而在分娩的发动与分娩的维持中起重要作用.

The plasma and amniotic fluid concentrations of endothelin-1 (ET-1) and prostaglandin E2 (PGE2) were measured by radioimmunoassay in 81 women, including 20 in the second stage of labor, 14 in the latent period, 15 in the third trimester of pregnancy, 10 in midtrimester, and 12 postpartum women ,and 10 normal nonpregnant women served as control. The results showed that the plasma ET-1 concentrations of women in second stage of labor, latent period, normal third trimester, and midtrimester of pregnancy were significantly higher than those of the normal nonpregnant and postpartum women and increased with pregnancy and labor, with a peak level in second stage of labor. At 24 hours postpartum, the plasma ET-1 concentrations decreased abruptly to the nonpregnant levels. The ET-1 and PGE2 concentrations in amniotic fluid were significantly higher than those in plasma, both at various stages of pregnancy and during labor. The PGE2 levels in plasma and amniotic fluid varied with the ET-1 levels and there was a significant positive correlation at various stages of pregnancy and during labor. The results suggest that ET-1 concentrations in plasma and amniotic fluid increases with gestational length, and produces contractions of pregnant my-ometrium at term. The ET-1 stimulats the production of PGE2 and plays an important role in the initiation and maintenance of labor.