中文摘要：

目的探讨促肾上腺皮质激素释放激素（CRH）、皮质醇、硫酸脱氢表雄酮（DHEA—S）在早产发动中的作用。方法用原位杂交法检测早产阴道分娩产妇26例（早产组）、足月临产阴道分娩产妇29例（足月临产组）、足月未临产剖宫产产妇25例（足月未临产组）胎盘、胎膜组织中CRH mRNA的分布与表达，用放射免疫法测定3组产妇分娩的新生儿脐静脉血CRH，脐动脉血DHEA-S及皮质醇的含量。结果（1）各组产妇胎盘、胎膜组织中均可见CRH mRNA表达。（2）CRH mRNA在胎盘组织中表达的阳性指数：早产组为5．5±1．4，足月临产组为5．4±1．5，均高于足月未临产组的2．7±1．5。差异均有统计学意义（P〈0．01）；CRHmRNA在胎膜组织中表达的阳性指数：早产组为5．4±1．7，足月临产组为5．4±1．4，足月未临产组为2．0±1．4，早产组、足月临产组与足月未临产组比较，差异也有统计学意义（P〈0．01）；CRH mRNA在胎盘及胎膜中表达的阳性指数早产组与足月临产组比较，差异无统计学意义（P〉0．05）；各组产妇CRH mRNA在胎盘与胎膜组织中的表达比较，差异均无统计学意义（P〉0．05）。（3）早产组和足月临产组新生儿脐静脉血CRH含量分别为（7．8±3．3）、（7．7±4．1）ng／L，脐动脉血DHEA-S含量分别为（514±295）、（483±207）μg／L，均高于足月未临产组的（4．8±2．4）ng／L、（360±80）μg／L，差异有统计学意义（P〈0．05）；而早产组与足月临产组比较，差异则无统计学意义（P〉0．05）。早产组脐静脉血CRH含量与胎盘、胎膜组织中CRH mRNA的表达均呈正相关关系（r=0．935、0．853，P〈0．01），足月临产组脐静脉血CRH含量与胎盘、胎膜组织中CRH mRNA的表达也呈正相关关系（r=0．902、0．825，P〈0．01）。（4）早产组新生儿脐动脉血皮质醇含量为（246±117）μg／L，明显高于足月?

英文摘要：

Objective To investigate the effect of corticotropin-releasing hormone （ CRH）, cortisol and dehydroepiandrosterone sulfate in pathogenesis of preterm labor. Methods A cross-sectional study was conducted including 80 pregnant women in the following categories： （1）preterm delivery in labor（ PL, n = 26）, （2） term in labor（ TL, n = 29 ）, （3） term not in labor （ n = 25 ）. The expression and localizations of CRH mRNA in placentas and fetal membranes in three groups respectively were examined by in situ hybridization. Radioimmunoassay was used to detect the levels of corticotropin releasing hormone, cortisol and dehydroepiandrosterone sulfate in fetal umbilical cord blood in three groups. Results （ 1 ） By in situ hybridization, we localized CRH mRNA to the syncytiotrophoblasts of placenta, the anmiotic epithelial cells and chorion cells. （ 2 ） The positive index of expression of CRH mRNA in fetal membranes of PL （ 5.4 ± 1.4） and TL, （5.4 ± 1.5 ） was higher than that in term not in labor, （2. 0 ± 1.4, P 〈 0. 01 ）. And there was no difference between PL and TL （ P 〉 0. 05 ）. The positive index of expression of CRH mRNA in placentas of PL（5.5 ± 1.4） and TL（5.4 ± 1.5） was higher than that in term not in labor（2. 7 ± 1.5, P 〈 0. 01 ）. And there was no difference between PL and TL（P 〉0. 05）. The expression of CRH mRNA was not distinct between placentas and fetal membranes in three groups （ P 〉 0. 05 ）. （ 3 ） The levels of CRH and DHEA-S in umbilical cord blood of PL（7. 8 ± 3.3 ）ng/L, and （514 ± 295 ） p,g/L, respectively and of TL （7. 7 ±4. 1 ） ng/L, and （483±207） μg/L, were higher than that in term not in labor（4. 8 ±2. 4） ng/L, and （360 ± 80） μg/L, respectively （ P 〈 0. 05 ）. And there was no difference between PL and TL （ P 〉 0. 05 ）. In PL, the level of CRH in umbilical cord blood and the expression of CRH mRNA in placentas and fetal membranes were correlated with each other（ r = 0.