Strecker J R, Negulescu R, Dahlén H, Musch K
Geburtshilfe Frauenheilkd. 1977 Jun;37(6):509-15.
Unconjugated oestrone (Oe1), oestradiol-17beta (Oe2), oestriol (Oe3), progesterone (P) and HPL in plasma were determined by radioimmunoassay and the immunological pregnancy-test in urine was carried out in 70 patients with normal pregnancy or imminent abortion from 4th-20th week of gestation. Oe2 and HPL showed the most pronounced rises, Oe3 increased especially after the first trimester. In cases with abortion symptoms and poor prognosis Oe2 and HPL gave the most reliable results concerning the endocrin function of early normal pregnancy. Oe1- and P-values in normal pregnancy did not differ so clearly from concentrations observed during normal menstrual cycles and were thus of less value. The pregnancy-test was positive (greater than 1000 IU/1) even in most cases of dead pregnancy and therefore not reliable. With increasing production of oestrogen precursors in the fetal adrenal cortex after the first trimester determination of Oe3 becomes more important. In cases with abortion symptoms in early pregnancy and subsequent normal development, plasma Oe2- and Oe3- values represented best criteria for a prognosis. -- For the diagnosis and control of the endangered early pregnancy we recommend, as a consequence of this study, determination of Oe2 up to the 13th week of pregnancy and thereafter Oe3 in maternal plasma.
采用放射免疫分析法测定血浆中未结合雌酮(Oe1)、雌二醇 - 17β(Oe2)、雌三醇(Oe3)、孕酮(P)和人胎盘催乳素(HPL),并对70例妊娠4至20周的正常妊娠或难免流产患者进行尿免疫妊娠试验。Oe2和HPL升高最为显著,Oe3尤其在孕早期后升高。在有流产症状且预后不良的病例中,Oe2和HPL对于早期正常妊娠的内分泌功能给出了最可靠的结果。正常妊娠中的Oe1和P值与正常月经周期中观察到的浓度差异不那么明显,因此价值较小。妊娠试验即使在大多数死胎病例中也呈阳性(大于1000 IU/1),因此不可靠。孕早期后,随着胎儿肾上腺皮质中雌激素前体产量的增加,测定Oe3变得更为重要。在孕早期有流产症状但随后正常发育的病例中,血浆Oe2和Oe3值是最佳的预后标准。—— 基于本研究结果,对于濒危早期妊娠的诊断和监测,我们建议在妊娠13周前测定Oe2,之后测定母体血浆中的Oe3。