Klimek Rudolf, Klimek Marek, Gralek Peter, Jasiczek Dariusz
Fertility Centre Cracow, Plac Szczepański 3, 31-011 Cracow, Poland.
Obstet Gynecol Int. 2012;2012:248926. doi: 10.1155/2012/248926. Epub 2012 May 15.
The aim of this paper was to confirm the efficacy of adrenocorticotropin depot (ACTH-depot) therapy in pregnancies with threatened miscarriage and preterm delivery through the desired stimulation of the adrenal glands controlled by the rest of organism. The activity of hypothalamic-pituitary-adrenal axis plays a key role in pregnancy. Such naturally stimulated endogenous corticosteroid hormones are free from unwanted side effects of their synthetics analogs. Low level of maternal blood ACTH and insufficient increase of induced by hypothalamic hormones oxytocinases (cystine-β-aminopeptidases) were indication to ACTH-depot therapy (0.5 mg/week) in our consecutive prospective studies. Contrary to antenatal use of synthetic corticosteroids, there are no temporal limits of this therapy, which has to be more often recommended into clinical prevention of fetal morbidity, treatment of premature delivery, and finally elimination of the newborn's mortality caused by the neuroendocrinological gestoses.
本文的目的是通过对机体其他部分所控制的肾上腺进行预期刺激,来证实促肾上腺皮质激素长效注射剂(ACTH长效注射剂)疗法在先兆流产和早产妊娠中的疗效。下丘脑 - 垂体 - 肾上腺轴的活动在妊娠中起关键作用。这种自然刺激产生的内源性皮质类固醇激素没有其合成类似物的不良副作用。在我们连续的前瞻性研究中,母体血液促肾上腺皮质激素水平低以及下丘脑激素诱导的催产素酶(胱氨酸 - β - 氨基肽酶)增加不足是使用ACTH长效注射剂疗法(0.5毫克/周)的指征。与产前使用合成皮质类固醇不同,这种疗法没有时间限制,在临床预防胎儿发病、治疗早产以及最终消除神经内分泌性妊娠病导致的新生儿死亡方面,更应经常推荐使用该疗法。