中文摘要：

目的 探讨宫颈机能不全孕妇血清松弛素水平的变化.方法 对象为2008年2月至2012年9月,在北京大学第三医院建档规律产检的首次妊娠并于妊娠26周前临床诊断为宫颈机能不全者及相应孕周未发生宫颈机能不全者（对照组）,各33例.排除双胎（多胎）妊娠、合并妊娠期高血压疾病、肾病、自身免疫病等全身疾病患者、既往因宫颈病变行宫颈锥切术及既往有宫颈机能不全病史的患者.比较两组病例妊娠第一期末的宫颈长度（cm）、孕前体质量指数（BMI）、是否合并糖尿病（DM）和（或）妊娠期糖尿病（GDM）、是否合并多囊卵巢综合征（PCOS）及妊娠结局等,并测定两组血清松弛素（RLN,mg/L）水平.结果 符合入选标准的宫颈机能不全孕妇共33例,其中流产15例（45.45％）,早产12例（36.36％）,足月产6例（18.18％）,终止妊娠孕周（30±6）周,孕前BMI（27±4） kg/m2,血清松弛素水平（2 748 ±82） mg/L.对照组共33例,其中流产1例（3.03％）,早产4例（12.12％）,足月产28例（84.85％）,终止妊娠孕周（38±4）周,孕前BMI（23±3）kg,/m2,血清松弛素水平（2 602±126） mg/L.病例组合并PCOS比例及合并DM和（或）GDM比例明显高于对照组（P＜0.01,＜0.05）,其妊娠结局较差（P＜0.01）,其孕前BMI水平及血清松弛素水平均比对照组明显升高,差异均有统计学意义（均P＜0.01）,非条件logistic回归显示,BMI和血清松弛素水平是宫颈机能不全的独立危险因素.结论 血清松弛素水平升高是宫颈机能不全的独立危险因素;PCOS孕妇可能更容易发生宫颈机能不全;血清松弛素对宫颈机能不全可能具有预测价值.

英文摘要：

Objective To analyze the serum relaxin and clinical character of cervical incompetence patients and normal pregnant women.Methods A total of 33 cervical incompetence patients （research group） and 33 normal pregnancy women with the same gestational age （control group） were recruited into the study.The serum relaxin level was detected with enzyme labeled immunosorbent assay （ELSIA） in the two groups,and the cervical length of early pregnancy period （cm）,body mass index （BMI,kg/m2）,frequency of polycystic ovary syndrome （%）,gestational diabetes mellitus/diabetes mellitus （%） and outcomes in the two groups were analyzed with independent samples t test and chi-square test.Results All the cervical incompetence patients were recruited between Feb.2008 and Sept.2012,with the average termination gestational age of 30 ±6 weeks.Among them,15 （45.45%） was abortion,12 （36.36%） was preterm birth,6 （16.18%） was term birth.The average BMI before pregnancy was 27 ±4 kg/m2,and the average serum relaxin was 2 748 ± 82 mg/L;for the 33 patients in the control group,the average termination gestational age was 38 ±3 weeks,and 1 （3.03%） of them was abortion,4 （12.12%） was preterm birth,28 （84.85%） was term birth.The average BMI before pregnancy was 23 ± 3 kg/m2,the average serum relaxin was 2 602 ± 126 mg/L.Compared with the control group,the research group had more patients who complicated with polycystic ovary syndrome and gestational diabetes mellitus/diabetes mellitus （P 〈 0.01,〈0.05） and worse pregnancy outcomes （P 〈 0.01）;the average BMI before pregnancy and the average serum relaxin level of the research group were significantly higher than control group （P 〈 0.01,P 〈 0.01）.Analysis through the unconditional logistic regression showed that BMI and serum relaxin were both independent risk factors of cervical incompetence.Conclusions The high level of serum relaxin is an independent risk factor of cervical incompetence;women with polycystic ovary syndro