【摘要】 目的:研究在妊娠妇女中前列腺素E2作用于宫颈引起一氧化氮的释放的效应,并分析了一氧化氮代谢产物、宫颈管长度和宫颈Bishop评分3者之间的关系。方法:选取了77例孕周≥37周的妊娠妇女,分别在使用前列腺素E2的前后检测宫颈分泌物中一氧化氮的浓度、进行宫颈Bishop评分、以及测量宫颈管的长度。结果:研究对象的平均年龄为(34±3.2)岁,平均孕龄为(284±9.2)d,其中初产妇占31.2%。在T0时间段,宫颈评分<4分的占74%(57/77),平均宫颈管长度为(28.6±5.8)mm,平均NOx的浓度为(208.6±103.8)μm/mL;而12 h后,在T12时间段,平均宫颈管长度减少到(19.5±8.8)mm,平均NOx的浓度增加到(316.7±240.9)μm/mL。而产次和需诱发宫缩的原因对数据没有影响。统计资料表明:宫颈一氧化氮代谢产物浓度的改变和宫颈Bishop评分的改善之间在统计学上呈显著的正相关P<0.01;r=0.494,一氧化氮代谢产物浓度的改变和宫颈管长度的缩短之间亦呈显著的正相关P<0.01;r=0.307。结论:前列腺素引起宫颈成熟的过程与宫颈局部一氧化氮的释放有相关性,故推测一氧化氮在宫颈组织重组的过程中起着重要作用。更多还原

【Abstract】 Objective:We studied the effect of the dinoprostone on cervical NO release in pregnant women,and we investigated the relationship between cervical NO metabolites,cervical length,and Bishop score.Methods:Seventy-seven women underwent induction of labor at ≥37 weeks of gestation,due to post-term pregnancy(23.8%),oligohydramnios(36.3%) or preeclampsia(29.9%).Cervical fluid samples for NO metabolites(NOx),Bishop score,and cervical length were assessed immediately before(time 0 )and 12 hours after(T12) the local application of dinoprostone,a commercially available prostaglandin E2(PGE2) analog.Results:The mean patients′ age was 34±3.2 years,mean gestational age at enrollment was 284±9.2 days,and nulliparous represented 31.2% of the study population.At time 0,Bishop score was less than 4 in 74%(57/77) of the subjects,mean cervical length was 28.6±5.8 mm,mean NOx concentration was 208.6±103.8 μm/mL;12 hours later,at T12,the mean cervical length decreased to19.5±8.8 mm,and the mean NOx concentration increased up to 316.7±240.9 μm/mL.Data were unaffected by parity or by regular uterine contraction patterns.A statistically significant positive correlation was found between changes in cervical NOx levels and Bishop score modification P<0.01;r=0.494,as well as between the modification of NO metabolites concentration and cervical shortening P<0.01;r=0.307.Conclusions:Prostaglandin(PG)-induced cervical ripening is associated with local NO release.NO plays an active role in cervical remodeling since it positively correlates with both cervical shortening and Bishop score increase.更多还原