Haning R V, Canick J A, Goldsmith L T, Shahinian K A, Erinakes N J, Weiss G
Department of Obstetrics and Gynecology, Brown University, Women and Infants' Hospital, Providence, RI 02905, USA.
Am J Obstet Gynecol. 1996 Jan;174(1 Pt 1):227-32. doi: 10.1016/s0002-9378(96)70399-x.
Our purpose was to determine the effects of fetal number, various ovulation induction treatments, and placental hormones on the concentration of maternal serum relaxin.
The concentrations of relaxin, human chorionic gonadotropin, estriol, and alpha-fetoprotein were determined in blood samples drawn at 16 to 18 weeks for prenatal diagnosis in 72 singleton and 115 twin pregnancies and analyzed by one-way analysis of variance, correlation analysis, and stepwise multiple linear regression of the log-transformed data.
The maternal serum concentrations of each of the four measured hormones were significantly higher in the twin pregnancies than in the singleton pregnancies: 1.4-fold for relaxin, 1.9-fold for human chorionic gonadotropin, 1.9-fold for estriol, and 2.2-fold for alpha-fetoprotein (all p < 0.01). The concentrations of each of the four hormones were significantly correlated with each of the others and with the number of fetuses (p < 0.01), except that estriol was not significantly correlated with human chorionic gonadotropin. The serum relaxin concentration in twin pregnancies after treatment with follicle-stimulating hormone and luteinizing hormone (menotropins) (n = 10) was 3.3-fold that in twins resulting from spontaneous ovulation (n = 89, p < 0.01). In twins resulting from in vitro fertilization or gamete intrafallopian transfer (n = 9) the serum relaxin concentration was 2.6-fold higher than in twins resulting from spontaneous ovulation (p < 0.01). The effect of clomiphene citrate (1.2-fold, n = 7) failed to reach statistical significance.
The second fetus causes a 1.4-fold increase in the concentration of maternal serum relaxin in twin pregnancies. Induction of ovulation with menotropins causes an additional 3.3-fold increase, whereas in vitro fertilization or gamete intrafallopian transfer treatment causes an additional 2.6-fold increase over that seen in twin pregnancies that followed spontaneous ovulation.
我们的目的是确定胎儿数量、各种促排卵治疗以及胎盘激素对母体血清松弛素浓度的影响。
在16至18周时采集血样，测定72例单胎妊娠和115例双胎妊娠中松弛素、人绒毛膜促性腺激素、雌三醇和甲胎蛋白的浓度，用于产前诊断，并对经对数转换的数据进行单因素方差分析、相关分析和逐步多元线性回归分析。
双胎妊娠中所测四种激素的母体血清浓度均显著高于单胎妊娠：松弛素为1.4倍，人绒毛膜促性腺激素为1.9倍，雌三醇为1.9倍，甲胎蛋白为2.2倍（均p<0.01）。四种激素中的每种激素浓度均与其他激素以及胎儿数量显著相关（p<0.01），但雌三醇与人绒毛膜促性腺激素无显著相关性。用促卵泡素和促黄体素（人绝经期促性腺激素）治疗后的双胎妊娠（n = 10）血清松弛素浓度是自然排卵双胎妊娠（n = 89，p<0.01）的3.3倍。体外受精或配子输卵管内移植后的双胎妊娠（n = 9）血清松弛素浓度比自然排卵双胎妊娠高2.6倍（p<0.01）。枸橼酸氯米芬的作用（1.2倍，n = 7）未达到统计学显著性。
在双胎妊娠中，第二个胎儿使母体血清松弛素浓度增加1.4倍。用人绝经期促性腺激素促排卵使松弛素浓度额外增加3.3倍，而体外受精或配子输卵管内移植治疗比自然排卵的双胎妊娠使松弛素浓度额外增加2.6倍。
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