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目的:探讨应激及其应对方式与早产和胎盘促肾上腺皮质激素释放激素(corticotropin releas-ing hormone,CRH)信使核糖核酸(mRNA)水平的相关性。方法:研究对象来自2003年6月至2005年3月在镇江第四人民医院产科分娩的单胎初产妇,早产组46例,正常产组42例;采用生活事件量表(LES)及防御方式问卷(DSQ)在第28周时进行自我评定,胎盘组织的CRH-mRNA的表达采用RT-PCR方法测定,以光密度值(OD值)作为观察数据。统计方法采用独立样本t检验和逐步回归分析。结果:早产组与正常产组在恶性生活事件频度和强度、DSQ的不成熟防御因子(DSQ1)分值的差异有显著性(P<0.05~0.001);早产因子、DSQ1分值与胎盘CRH-mRNA的相对含量(OD值)呈正相关,偏回归系数分别为0.552和0.345,t值分别为5.693和3.618,P值均<0.001。结论:心理应激及其应对方式与早产的发生相关,胎盘CRH-mRNA的高度表达可能是心理应激与早产发生的病理生理中介机制。
Objective: To investigate the relationship between stress and coping style and prenatal and placental corticotropin relea-ing hormone (CRH) messenger RNA (mRNA) levels. Methods: The subjects were from single-fetus labor in obstetric delivery in Zhenjiang Fourth People’s Hospital from June 2003 to March 2005. There were 46 cases of preterm labor and 42 cases of normal labor. Life events scale (LES) Questionnaire (DSQ) self-assessed at week 28, CRH-mRNA expression in placenta was measured by RT-PCR and optical density (OD) values were taken as observation data. Statistical methods using independent sample t-test and stepwise regression analysis. Results: The frequency and intensity of malignant life events and DSQ1 scores of DSQ1 in preterm group and normal group were significantly different (P <0.05-0.001). Preterm birth factor, DSQ1 score and CRH in placenta -mRNA (OD value) was positively correlated, partial regression coefficients were 0.552 and 0.345, t values were 5.693 and 3.618, P values were <0.001. Conclusion: The psychological stress and coping style are related to the occurrence of prematurity. The high expression of CRH-mRNA in the placenta may be the pathophysiological mechanism of psychological stress and premature labor.