Goland R S, Jozak S, Conwell I
Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032.
Am J Obstet Gynecol. 1994 Nov;171(5):1287-91. doi: 10.1016/0002-9378(94)90149-x.
Our purpose was to clarify whether placental corticotropin-releasing hormone regulates pituitary-adrenal function in human pregnancy.
We examined the relationship between maternal plasma corticotropin-releasing hormone concentrations and levels of pituitary-adrenal hormones at 5-week intervals in 21 uncomplicated term pregnancies.
Maternal plasma corticotropin-releasing hormone concentrations rose significantly from 115 +/- 45 pg/ml at 11 to 15 weeks to 4346 +/- 754 pg/ml at 36 to 40 weeks (p < 0.001). Afternoon plasma corticotropin concentrations also rose significantly from 8.8 +/- 2.8 pg/ml to 18 +/- 2.6 pg/ml (p < 0.005). Urinary free cortisol concentrations rose from 54.8 +/- 7.3 micrograms per 24 hours to 111 +/- 8.7 micrograms per 24 hours (p < 0.005). Maternal dehydroepiandrosterone sulfate levels fell from 102 +/- 14 micrograms/dl to 63.8 +/- 7.1 micrograms/dl (p < 0.005). Maternal plasma corticotropin-releasing hormone was significantly correlated with afternoon plasma corticotropin concentrations (r = 0.6, p < 0.0001) and with urinary free cortisol concentrations (r = 0.04, p < 0.01).
Similar modest elevations of corticotropin and cortisol, as occur in pregnancy, have been reported in vitro and in vivo studies of long-term administration of corticotropin-releasing hormone. Our findings support the concept that placental corticotropin-releasing hormone modulates pituitary-adrenal function in pregnancy.
我们的目的是阐明胎盘促肾上腺皮质激素释放激素是否调节人类孕期的垂体 - 肾上腺功能。
我们在21例无并发症的足月妊娠中，每隔5周检测母体血浆促肾上腺皮质激素释放激素浓度与垂体 - 肾上腺激素水平之间的关系。
母体血浆促肾上腺皮质激素释放激素浓度从孕11至15周时的115±45 pg/ml显著升至孕36至40周时的4346±754 pg/ml（p<0.001）。下午血浆促肾上腺皮质激素浓度也从8.8±2.8 pg/ml显著升至18±2.6 pg/ml（p<0.005）。尿游离皮质醇浓度从每24小时54.8±7.3微克升至每24小时111±8.7微克（p<0.005）。母体硫酸脱氢表雄酮水平从102±14微克/分升降至63.8±7.1微克/分升（p<0.005）。母体血浆促肾上腺皮质激素释放激素与下午血浆促肾上腺皮质激素浓度显著相关（r = 0.6，p<0.0001），与尿游离皮质醇浓度也显著相关（r = 0.04，p<0.01）。
长期给予促肾上腺皮质激素释放激素的体外和体内研究报告显示，孕期出现的促肾上腺皮质激素和皮质醇的适度升高与之相似。我们的研究结果支持胎盘促肾上腺皮质激素释放激素在孕期调节垂体 - 肾上腺功能这一概念。
