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目的探讨胎盘和子宫平滑肌组织中尿皮质素(urocortin,UCN)对子宫平滑肌收缩功能的影响,及UCN mRNA表达变化在分娩发动、进展中的作用。方法(1)采用半定量RT-PCR技术检测10例未临产妇女(未临产组)及20例临产妇女(临产组,其中10例潜伏期、10例活跃期)的胎盘组织和子宫平滑肌组织中UCN mRNA表达水平;(2)另取24例剖宫产术分娩产妇的子宫平滑肌组织(实验样本)行离体收缩实验,观察不同剂量UCN对子宫平滑肌的收缩作用,以及对由前列腺素F2α(PGF2α)、缩宫素诱发的子宫平滑肌收缩活动的影响,以收缩曲线下面积表示。结果(1)临产组胎盘组织中UCNmRNA的表达水平为1·23±0·52,高于未临产组的0·83±0·38,两组比较,差异有统计学意义(P<0·05);临产组子宫平滑肌组织中UCN mRNA的表达水平为1·32±0·22,高于未临产组的0·94±0·13,两组比较,差异有统计学意义(P<0·05)。临产组活跃期产妇的胎盘组织及子宫平滑肌组织中UCN mRNA表达水平明显高于潜伏期产妇,两者分别比较,差异有统计学意义(P<0·05)。(2)实验样本对不同剂量UCN均无反应,收缩曲线下面积无变化;但在加入UCN的基础上再加入PGF2α,可引起子宫平滑肌收缩曲线下面积由(2·12±0·15)cm2增加到(3·90±0·33)cm2,两者比较,差异有统计学意义(P<0·05);但UCN对缩宫素引起的子宫平滑肌收缩曲线下面积无影响。结论UCN本身对子宫平滑肌收缩功能无影响,但可以增加PGF2α及缩宫素对子宫平滑肌的收缩作用,从而参与分娩的发动和维持。
Objective To investigate the effect of urocortin (UCN) on contractile function of uterine smooth muscle in placenta and uterine smooth muscle and the role of UCN mRNA in onset and progression of labor. Methods (1) Semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect the expression of UCN in placenta and uterine smooth muscle of 10 non-pregnant women (non-labor group) and 20 pregnant women (labor group, 10 cases of incubation and 10 cases of active) (2) The uterine smooth muscle tissue (experimental sample) of 24 pregnant women delivered by cesarean section was performed in vitro contractility test to observe the contractile effect of different doses of UCN on uterine smooth muscle and the effect of prostaglandin F2α (PGF2α ), Oxytocin-induced uterine smooth muscle contraction activity, expressed as the area under the contraction curve. Results (1) The expression level of UCN mRNA in placenta of labor group was 1.23 ± 0.52, which was higher than that of non-labor group (0 · 83 ± 0.38), the difference was statistically significant (P <0. 05). UCN mRNA expression level in uterine smooth muscle of working group was 1.332 ± 0.22, which was higher than that of non-working group (0.94 ± 0.13), the difference was statistically significant (P <0 · 05). UCN mRNA expression levels in placenta and uterine smooth muscle tissues of active parturient women in active labor group were significantly higher than those in latent labor women, the difference was statistically significant (P <0.05). (2) The experimental samples did not respond to different doses of UCN and the area under the curve of contraction did not change. However, adding UGF into PGF2α could cause the area under the curve of uterine smooth muscle contraction to be (2.12 ± 0.155) cm2 (3.90 ± 0.33) cm2, the difference was statistically significant (P <0.05); however, UCN had no effect on the area under the uterine smooth muscle contraction curve induced by oxytocin. Conclusion UCN itself has no effect on the contractile function of uterine smooth muscle, but it can increase the contractile effect of PGF2α and oxytocin on uterine smooth muscle to participate in the onset and maintenance of labor.