【摘要】 目的研究不同胎龄胎儿脐带血17α-羟孕酮(17α-OHP)浓度分布状况,了解胎儿17α-OHP浓度生理变化特征。方法利用Wallac1420 VICTOR分析仪,应用时间分辨荧光免疫分析法(TRFIA)检测胎儿脐带血及新生儿足跟血制成的滤纸干血片中17α-OHP的浓度,并收集相关临床资料进行分析。结果妊娠17~30+6周胎儿脐带血17α-OHP浓度与性别无关,男、女胎儿比较差异无统计学意义(t=-2.55,P>0.05)。妊娠17~18+6周、19~20+6周、21~22+6周、23~24+6周、25~26+6周、27~28+6周、29~30+6周17α-OHP参考值范围分别为0.0~58.3 nmol/L、6.3~75.6 nmol/L、3.7~43.7 nmol/L、3.5~37.6 nmol/L、5.5~31.4 nmol/L、7.1~35.3 nmol/L和3.5~31.0 nmol/L,各组间比较差异均有统计学意义(χ2=93.08,P<0.01)。孕17~30+6周17α-OHP浓度分布特征为随胎龄增加而增高至最高值,然后呈波动下降,在分娩前又逐渐升高。最高值在妊娠19周,为31.6 nmol/L。同一胎龄的胎儿期与新生儿期比较结果显示,胎儿期的17α-OHP低于新生儿期,差异有统计学意义(t=3.516,P<0.05)。结论胎儿脐带血17α-OHP生理变化规律是依赖于胎儿肾上腺发育成熟过程中酶的调节作用、胎盘功能及分娩前胎儿下丘脑-垂体-肾上腺(HPA)轴的发动,了解胎儿17α-OHP浓度生理变化特征具有临床意义。更多还原

【Abstract】 Objective To research the distribution of concentrations of 17α-hydroxyprogesterone in umbilical cord blood of fetuses of different gestational ages,understand the characteristics of physiological changes of fetal 17α- hydroxyprogesterone concentrations.Methods Wallac1420 VICTOR analyzer was used in the study; time-resolved fluoroimmunoassay was used to detect the concentrations of17α-hydroxyprogesterone in fetal umbilical cord blood and neonatal heel blood via dried blood spot determination; related clinical data was collected and analyzed. Results During 17 ~ 30+6gestational weeks,17α- hydroxyprogesterone in fetal umbilical cord blood was not correlated with gender,there was no statistically significant difference between male fetuses and female fetuses( t =-2. 55,P>0. 05). The reference ranges of 17α- hydroxyprogesterone during 17 ~ 18+6gestational weeks,19 ~ 20+6gestational weeks,21 ~ 22+6gestational weeks,23 ~ 24+6gestational weeks,25 ~ 26+6gestational weeks,27 ~28+6gestational weeks,and 29 ~ 30+6gestational weeks were 0. 0 ~ 58. 3 nmol / L,6. 3 ~ 75. 6 nmol / L,3. 7 ~ 43. 7 nmol / L,3. 5 ~37. 6 nmol / L,5. 5 ~ 31. 4 nmol / L,7. 1 ~ 35. 3 nmol / L,and 3. 5 ~ 31. 0 nmol / L,respectively,there was statistically significant difference among different gestational weeks( χ2= 93. 08,P<0. 01). The concentration of 17α-hydroxyprogesterone during 17 ~ 30+6gestational weeks increased to the peak concentration with gestational age,then it went down undulated and increased gradually before delivery. The peak concentration of 17α- hydroxyprogesterone appeared on the 19 th gestational week,which was 31. 6 nmol / L. The concentration of 17α-hydroxyprogesterone during fetal period was statistically significantly lower than that during neonatal period in the same gestational age group( t=3. 516,P<0. 05). Conclusion The physiological change regularity of 17α-hydroxyprogesterone in fetal umbilical cord blood depends on regulating effect of enzymes in the course of fetal adrenal maturation,placental function,and activation of fetal hypothalamic pituitary adrenal( HPA) axis prior to birth,understanding the characteristics of physiological changes of fetal 17α-hydroxyprogesterone has clinical significance.更多还原