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目的 观察表皮生长因子 (EGF)和胰岛素 (insulin)对早期妊娠人工流产的新鲜绒毛组织分泌绒毛膜促生长催乳素 (HCS)和绒毛膜促性腺激素 (HCG)的影响。方法 选择孕 6～ 10周要求行人工流产术的健康孕妇5 5例 ,取其绒毛组织进行灌流。用不同质量浓度的EGF作用于绒毛 ,同时观察胰岛素及不同质量浓度葡萄糖对绒毛分泌HCS及HCG的影响。用放免方法测定灌洗液中HCS和HCG含量。结果 EGF对早孕绒毛分泌HCS和HCG有双向作用。即 :EGF(5 0 μg/L)对HCS和HCG的分泌有明显的促进作用 (P <0 0 1) ,而高质量浓度EGF(5 0 0 μg/L)对其分泌有抑制作用 (P <0 0 5 )。胰岛素可使离体早孕绒毛分泌HCS和HCG有所增加 ,并证实另一主要影响因素为葡萄糖质量浓度 ,即 :高量浓度葡萄糖 (4 0g/L)抑制HCS及HCG分泌 (P <0 0 5 ) ,而低质量浓度葡萄糖 (0 4 g/L)促进其分泌 (P <0 0 1)。胰岛素可增强EGF诱导的HCS及HCG分泌 (P <0 0 0 1) ,说明胰岛素可协同EGF的促细胞分化作用 ,提示胰岛素对胎盘分泌HCS及HCG起重要作用。结论 EGF对HCS及HCG分泌的影响作用是一致的 ;胰岛素间接使胰岛素样生长因子 -Ⅰ (IGF -Ⅰ )发挥作用使滋养细胞分泌HCS及HCG增加 ;胰岛素尚可协同EGF发挥其促细胞分化作用。
Objective To investigate the effects of epidermal growth factor (EGF) and insulin on the secretion of chorionic gonadotropin (HCS) and human chorionic gonadotropin (HCG) by fresh villi in early pregnancy induced abortion. Methods Fifty-five healthy pregnant women who required artificial abortion during pregnancy from 6 to 10 weeks were selected for peritoneal perfusion. Effect of different concentrations of EGF on villi, insulin and different concentrations of glucose on HCT and HCG secretion were observed. Determination of HCS and HCG in lavage fluid by radioimmunoassay. Results EGF had a bidirectional effect on the secretion of HCS and HCG from early villi. In other words, EGF (50 μg / L) significantly promoted the secretion of HCS and HCG (P <0.01), whereas EGF (500 μg / L) inhibited the secretion of HCS and HCG (P <0 0 5). Insulin could increase the excretion of HCS and HCG in ex vivo villus and confirmed that the other main influencing factor was glucose concentration: high concentration glucose (40g / L) inhibited the secretion of HCS and HCG (P <0.05 ), While low-quality glucose (0 4 g / L) promoted secretion (P <0.01). Insulin can enhance EGF-induced HCS and HCG secretion (P <0.01), indicating that insulin can cooperate with EGF promoting cell differentiation, suggesting that insulin secretion of HCS and HCG plays an important role in the placenta. Conclusion The effect of EGF on HCS and HCG secretion is consistent. Insulin indirectly induces the secretion of HCS and HCG from trophoblasts by insulin-like growth factor-I (IGF-Ⅰ) .