Sippell W G, Müller-Holve W, Dörr H G, Bidlingmaier F, Knorr D
J Clin Endocrinol Metab. 1981 Mar;52(3):385-92. doi: 10.1210/jcem-52-3-385.
Corticosteroids (CS) are essential for fetal organ maturation; yet, knowledge of endogeneous CS and precursor levels throughout fetal life is limited. Therefore, unconjugated aldosterone (Aldo), corticosterone (B), 11-deoxycorticosterone (DOC), progesterone (P), 17 alpha-hydroxyprogesterone (17-OHP), 11-deoxycortisol (S), cortisol (F), and cortisone (E) were simultaneously determined by RIA after automated Sephadex LH-20 chromatography in 70 control samples of amniotic fluid (AF) obtained at all gestational ages between 14-42 weeks. Levels of the progestins P and 17-OHP slowly increased from means (+/- SE) of 14.7 +/- 2.8 and 1.63 +/- 0.21 ng/ml, respectively, in early gestation to maximum levels of 32.4 +/- 3.5 and 3.80 +/- 0.74 ng/ml at 36-38 weeks (P less than 0.005), then dropped significantly (P less than 0.01) to 19.2 +/- 2.2 and 1.58 +/- 0.22 ng/ml at term. All CS levels except E rose very markedly by 3- to 12-fold (P less than 0.0001) from the weeks 14-16 (DOC, 0.44 +/- 0.08; B, 1.49 +/- 0.23; Aldo, 0.043 +/- 0.012; S, 0.51 +/- 0.10; F, 5.96 +/- 0.93 ng/ml) until the 36-38th weeks (DOC, 3.50 +/- 0.66; B, 4.60 +/- 0.78; Aldo, 0.530 +/- 0.109; S, 6.00 +/- 0.75; F, 60.8 +/- 8.9 ng/ml). Term levels were significantly reduced (P less than 0.01) in the less active CS DOC (0.51 +/- 0.07 ng/ml), B (2.35 +/- 0.35 ng/ml), and S (1.14 +/- 0.14 ng/ml), whereas those of the biologically most potent CS Aldo and F declined less markedly (0.272 +/- 0.053 and 23.0 +/- 0.75 ng/ml, respectively, at 39-42 weeks). Levels of the inactive glucocorticoid E rose from 8.83 +/- 1.08 ng/ml at 14-16 weeks to 16.8 +/- 2.6 ng/ml at 31-35 weeks (P less than 0.01), then remained rather constant around 11.5 ng/ml until term. It is concluded that after the 25th week, large amounts of biologically active CS are available in AF which probably directly induce the final epithelial maturation of fetal lungs and intestinal tract.
皮质类固醇（CS）对胎儿器官成熟至关重要；然而，关于胎儿期内源性CS及其前体水平的了解有限。因此，在14至42周所有孕周获取的70份羊水（AF）对照样本中，通过自动葡聚糖凝胶LH - 20柱色谱法后用放射免疫分析法（RIA）同时测定了未结合的醛固酮（Aldo）、皮质酮（B）、11 - 脱氧皮质酮（DOC）、孕酮（P）、17α - 羟孕酮（17 - OHP）、11 - 脱氧皮质醇（S）、皮质醇（F）和可的松（E）。孕激素P和17 - OHP的水平在妊娠早期分别从均值（±标准误）14.7±2.8和1.63±0.21 ng/ml缓慢升高，在36 - 38周时达到最高水平32.4±3.5和3.80±0.74 ng/ml（P＜0.005），然后在足月时显著下降（P＜0.01）至19.2±2.2和1.58±0.22 ng/ml。除E外，所有CS水平在14 - 16周（DOC，0.44±0.08；B，1.49±0.23；Aldo，0.043±0.012；S，0.51±0.10；F，5.96±0.93 ng/ml）至36 - 38周（DOC，3.50±0.66；B，4.60±0.78；Aldo，0.530±0.109；S，6.00±0.75；F，60.8±8.9 ng/ml）期间显著升高3至12倍（P＜0.0001）。足月时，活性较低的CS即DOC（0.51±0.07 ng/ml）、B（2.35±0.35 ng/ml）和S（1.14±0.14 ng/ml）水平显著降低（P＜0.01），而生物活性最强的CS即Aldo和F的水平下降不那么明显（在39 - 42周时分别为0.272±0.053和23.0±0.75 ng/ml）。无活性糖皮质激素E的水平从14 - 16周时的8.83±1.08 ng/ml升至31 - 35周时的16.8±2.6 ng/ml（P＜0.01），然后在足月前一直保持在11.5 ng/ml左右。结论是，在第25周后，羊水中有大量生物活性CS，这可能直接诱导胎儿肺和肠道的最终上皮成熟。
