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孕期及分娩期母血与胎儿血中儿茶酚胺(去甲肾上腺素、肾上腺素)及肾上腺类固醇(双氢表雄酮硫酸盐、皮质醇)水平的相关性

[Correlation between the levels of catecholamines (noradrenaline, adrenaline) and adrenal steroids (DHA-S, cortisol) in maternal and fetal blood during pregnancy and labor].

作者信息

Suzuki A, Hashino M, Chiba H, Saito H, Notake Y, Yanaihara T, Nakayama T

机构信息

Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.

出版信息

Nihon Naibunpi Gakkai Zasshi. 1989 Aug 20;65(8):704-14. doi: 10.1507/endocrine1927.65.8_704.

Abstract

It is known that both catecholamines (CA) and cortisol (F) levels elevate during labor. To determine the correlation between adrenal steroids and medullary function, maternal blood was collected during pregnancy, first stage of labor (MVI) and at delivery (MVII). Umbilical arterial and venous blood (UA, UV) was also obtained at delivery. Further, ACTH or dexamethasone (Dx) was given during the first stage of labor, and maternal blood was collected before and 30 minutes after the administration. Plasma levels of CA[noradrenaline (NA), adrenaline (Ad)] were extracted by trihydroxyindole method and were measured by HPLC. DHA-S and F levels were determined by specific RIA. Results are as follows: 1. No apparent change was observed in maternal NA and Ad levels throughout pregnancy. DHA-S levels were high in first trimester and decreased as pregnancy advanced, while F levels showed an increase trend as pregnancy progressed. 2. All hormone levels in maternal blood increased remarkably during labor. A significant negative correlation between F and Ad levels at delivery was noted. When F levels were elevated by ACTH administration, Ad levels decreased. Ad levels elevated when F levels were suppressed by Dx administration. 3. NA, Ad and DHA-S levels in cord blood were higher than those in MVII. Levels of F in maternal blood were higher than those in cord blood. A significant correlation of F in MVII and UA was observed. These results indicate that the suppressive effect of F may be involved in the mechanism of Ad secretion, though the secretion of Ad increased with F in the course of labor. The response of fetal adrenal to the stress of labor may be different from that of maternal adrenal since a significant correlation was not noticed between the levels of Ad and cortisol in cord blood as was found in maternal blood.

摘要

众所周知,在分娩过程中儿茶酚胺(CA)和皮质醇(F)水平都会升高。为了确定肾上腺类固醇与髓质功能之间的相关性,在孕期、分娩第一阶段(MVI)和分娩时(MVII)采集了母体血液。在分娩时还获取了脐动脉和脐静脉血(UA、UV)。此外,在分娩第一阶段给予促肾上腺皮质激素(ACTH)或地塞米松(Dx),并在给药前和给药后30分钟采集母体血液。采用三羟基吲哚法提取血浆中CA[去甲肾上腺素(NA)、肾上腺素(Ad)]水平,并通过高效液相色谱法进行测定。采用特异性放射免疫分析法测定脱氢表雄酮硫酸盐(DHA - S)和F水平。结果如下:1. 在整个孕期母体NA和Ad水平未观察到明显变化。孕早期DHA - S水平较高,随着孕期进展而下降,而F水平随着孕期进展呈上升趋势。2. 在分娩过程中母体血液中所有激素水平均显著升高。在分娩时F和Ad水平之间存在显著负相关。当通过给予ACTH使F水平升高时,Ad水平下降。当通过给予Dx抑制F水平时,Ad水平升高。3. 脐血中NA、Ad和DHA - S水平高于MVII中的水平。母体血液中F水平高于脐血中的水平。观察到MVII中的F与UA中的F存在显著相关性。这些结果表明,尽管在分娩过程中Ad的分泌随着F增加,但F的抑制作用可能参与了Ad分泌的机制。胎儿肾上腺对分娩应激的反应可能与母体肾上腺不同, 因为在脐血中未发现Ad和皮质醇水平之间存在如母体血液中那样的显著相关性。

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