抗雌激素药三苯氧胺对早孕妇女胎盘绒毛hCG和孕酮分泌的作用

EFFECTS OF ANTIESTROGENIC DRUG TAMOXIFEN ON HUMAN PLACENTAL SECRETION OF PROGESTERONE AND HUMAN CHOR IONIC GONADOTROPIN DURING EARLY GESTATION

早孕妇女人流绒毛体外培养4日,加入或不加入抗雌激素药物三苯氧胺,每日收集培养液并用RIA测定孕酮和hCG,以观察三苯氧胺对绒毛hCG和孕酮分泌的作用及其时间过程。结果表明,用药组d3,4收集的培养液内孕酮和hCG量明显低于对照组,提示三苯氧胺对早孕妇女胎盘绒毛的分泌有直接抑制作用。其抑制作用出现缓慢,与临床用药4～5d增强前列腺素制剂终止早孕的事实相符。三苯氧胺抑制早孕妇女胎盘绒毛分泌功能的作用可能与其降低胎盘绒毛对GnRH的反应性有关。

Placental villus tissue obtained from pregnant women of 6 to 7 weeks was cultured in vitro for four clays, with or without addition of tamoxifen (Tam), an antiestrogenic drug. The levels of both progesterone (P) and human chorionic gonadotropin (hCG)in culture medium collected every day were measured by using radio-immuno assay, so as to observe the effects of Tam on the secretion of P and hCG by villus tissue as well as the time course of these effects.The experimental results showed that the levels of both P and hCG in the culture medium collected on the 3rd and 4th days in the Tam-treated group were significantly lower than those in the control group, indicating that Tam could have a direct inhibitory effect on the secretory function of the placental villus tissue during early pregnancy. The slow onset of the inhibitory effect was in correspondence with the clinical observation that the early pregnancy terminating effect of PGS would be potentiated after 4～5 days of Tam medication. In addition, this inhibitory effect of tamoxifen on the placental secretory function was suggested to be associated with a decrease in the responsiveness of placental tissue to GnRH.