CAJ | 학술논문

目的：比较早产及足月分娩剖宫产产妇血清肾上腺皮质激素释放激素（ CRH）水平及子宫下段中促肾上腺皮质激素释放激素受体-1（CRH-R1）的表达情况，分析其在分娩发动中的作用。方法按难免早产、足月分娩发动、足月分娩未发动分为3组，术前测定血清中CRH水平，于剖宫产中取子宫下段平滑肌，用免疫组化的方法检测CRH-R1在子宫下段的表达。结果3组间CRH水平差异无统计学意义（P＞0．05），均为孕期较高水平。难免早产组、足月分娩发动组CRH-R1在子宫下段肌层中呈高表达状，其表达指数明显高于足月分娩未发动组（t值分别为5．000、6．295，均P＜0．05）。难免早产组、足月分娩发动组CRH-R1在子宫下段肌层中的表达差异无统计学意义（P＞0．05）。结论 CRH为参与人类分娩启动因子之一。母体血浆CRH水平有望作为早产预测和预后指标，其作用的发挥还有赖于子宫体中CRH-R1的表达。
목적：비교조산급족월분면부궁산산부혈청신상선피질격소석방격소（ CRH）수평급자궁하단중촉신상선피질격소석방격소수체-1（CRH-R1）적표체정황，분석기재분면발동중적작용。방법안난면조산、족월분면발동、족월분면미발동분위3조，술전측정혈청중CRH수평，우부궁산중취자궁하단평활기，용면역조화적방법검측CRH-R1재자궁하단적표체。결과3조간CRH수평차이무통계학의의（P＞0．05），균위잉기교고수평。난면조산조、족월분면발동조CRH-R1재자궁하단기층중정고표체상，기표체지수명현고우족월분면미발동조（t치분별위5．000、6．295，균P＜0．05）。난면조산조、족월분면발동조CRH-R1재자궁하단기층중적표체차이무통계학의의（P＞0．05）。결론 CRH위삼여인류분면계동인자지일。모체혈장CRH수평유망작위조산예측화예후지표，기작용적발휘환유뢰우자궁체중CRH-R1적표체。
Objective To compare the level of serum corticotrophin-releasing hormone (CRH) and expression of corticotropin-releasing hormone receptor 1 ( CRH-R1) in lower uterine segment of pregnant women undergoing preterm and term birth cesarean section , and to analyze their role in laboronset .Methods Patients were divided into three groups according to inevitable premature birth , term labor onset and term labor without onset .Serum CRH level was tested before operation .In cesarean section myometrial samples were collected from the lower uterine segment to detect CRH-R1 expression with immunohistochemical method .Results CRH levels were not significantly different among three groups (P>0.05), and they were at relatively high level during pregnancy .In the group of inevitable premature birth and the group of term labor onset CRH-R1 was highly expressed in the lower uterine segment muscle layer , and its expression index was obviously higher than that of the group of term labor without onset (t value was 5.000 and 6.295, respectively, both P<0.05).The expression of CRH-R1 in the lower uterine segment muscle layer was not significantly different between the group of inevitable premature birth and the group of term labor onset (P>0.05).Conclusion CRH is one of the initiators of labor onset .Maternal plasma level of CRH may be an index for premature forecast and prognosis , and the role of it depends on CRH-R1 expression in uterus .