雌、孕激素受体的表达对分娩发动的影响

Effect of expressions of estrogen receptor and progestogen receptor on initiation of parturition

目的 检测雌、孕激素受体在自然临产经阴道分娩以及选择性剖宫产产妇胎盘组织中的表达，探讨雌、孕激素受体的表达对分娩发动的影响及机制。方法 运用免疫组化法检测22例自然临产经阴道分娩产妇（实验组）胎盘组织中雌、孕激素受体的表达情况；以18例选择性剖宫产为对照组，并结合临床资料对实验数据进行统计学分析。结果 ①实验组和对照组产妇胎盘组织中孕激素受体阳性率分别为（73.79±13.09）%和（74.02±14.40）%，两组经比较差异无统计学意义（t=0.094，P〉0.05）；②实验组和对照组产妇胎盘组织中的雌激素受体阳性表达率分别为（86.11±14.90）%和（82.65±14.30）%，两组经比较雌激素受体表达水平变化不大，差异无统计学意义（t=-1.374，P〉0.05）。结论 人类妊娠末期至分娩发动前，雌、孕激素受体在产妇妊娠组织中的表达水平均无显著下降。功能性孕激素撤退可能就是分娩发动的启动因素。

Objective To detect expressions of estrogen receptor（ER） and progesterone receptor（PR） in placental tissues obtained from natural vaginal delivery and elective cesarean section and to investigate effect of expressions of ER and PR on initiation of parturition and the mechanisms. Methods By using immunohistochemistry method, expressions of ER and PR in placental tissues of 22 parturients who underwent natural vaginal delivery in the experiment group and 18 parturients who underwent elective cesarean section in the control group were detected. The clinical and laboratory data were analyzed statistically. Results ①In positive expression rate of PR in placental tissues, there was not significant difference between the natural vaginal delivery group and the control group, ／[（73.91±13.09）% vs （74.02±14.40）%, t=0.094, P〉0.05／]; ② In positive expression rate of ER in placental tissues, there was also not significant difference between the natural vaginal delivery group and the control group ／[（86.11±14.90）% vs （82.65±14.30）%, t=-1.374, P〉0.05／]. Conclusion In the period from late pregnancy to initiation of parturition in human parturition, the levels of expressions of ER and PR in circulation and pregnancyassociated tissues are not decreased significantly. Functional progesterone withdrawal may be the trigger of initiation of parturition.