正常妊娠妇女内源性类洋地黄物质来源的研究

The Source of Endogenous DigitalisLike Substance in Normal Pregnancy

目的研究正常妊娠妇女外周血中增高的内源性类洋地黄物质（ＥＤＬＳ）的来源。方法采用放射免疫分析法测定早孕绒毛，晚孕胎儿附属物组织，正常非孕妇女，早、中、晚孕期，产后２４～４８小时，产时孕妇外周血及脐血中ＥＤＬＳ含量。结果早孕绒毛、胎盘、胎膜及脐带胶质中ＥＤＬＳ含量分别为孕妇外周血的３７、３３、２９和２４倍；胎儿附属物组织间ＥＤＬＳ含量呈显著正相关。早、中孕期血浆ＥＤＬＳ含量与正常非孕妇女比较无明显差异，孕晚期则明显升高，产后２４～４８小时明显下降。孕晚期外周血ＥＤＬＳ含量与平均动脉压（ＭＡＰ）和孕周呈正相关。脐静脉和脐动脉血ＥＤＬＳ含量为外周血的３．１和２．９倍，且脐血和外周血ＥＤＬＳ与胎盘和胎儿的重量之和呈正相关。

Objective To study the source of endogenous digitialislike substance (EDLS) which increases in maternal vein plasma during normal pregnancy. Methods The EDLS concentrations in following samples: (1) villi in the 1st trimester (2) placenta, amnion and umbilical jelly of Wharton in the 3rd trimester, (3) plasma of normal nonpregnant women (4) maternal plasma in three trimesters, 24～48 hours post partum, (5) maternal plasma and umbilical blood in labour, were determined by radioimmunoassay. Results The concentration of EDLS in villi, placenta, amnion and jelly of Wharton was about 37, 33, 29 and 24 times higher respectively than the concentration of maternal blood. There was a significant positive correlation between the concentrations of EDLS in placenta or amnion and that in jelly of Wharton. Plasma EDLS levels in pregnant women of 1st and 2nd trimesters were similar to that in nonpregnant women, while in the 3rd trimester of pregnany they were significantly increased, and then significantly decreased in 24 to 48 hours post partum. There was a significant positive correlation between the plasma EDLS level and mean arterial pressure in the 3rd trimester. The EDLS concentration in plasma of umbilical vein and artery was about 3.1 and 2.9 times higher respectively than that in the maternal plasma. There were significant positive correlations between plasma EDLS levels of umbilical vein, artery or maternal vein and the weight of placenta or newborn. Conclusion The fetalplacenta unit is the source of EDLS which increases in maternal vein plasma during normal pregnancy.