初产妇妊娠晚期血雌、孕激素和松弛素水平与压力性尿失禁的相关性

摘要

目的 探讨初产妇妊娠晚期血清雌、孕激素和松弛素水平与压力性尿失禁( SUI)的关系以及妊娠期SUI的可能发病机制.方法 选取2009年9月至2010年2月,在上海交通大学附属第六人民医院产科门诊定期产检的初产孕妇71例.根据孕期有无SUI症状,分为尿失禁组(33例)和非尿失禁组（38例）.于孕36 ～40周抽肘静脉血5mL应用免疫化学发光法检测血清雌二醇(E2)、雌三醇(E3)和孕酮(P)水平,ELISA法检测血清松弛素H2水平.结果 尿失禁组和非尿失禁组血清E2分别为（89.2±28.3）nmol/L和(88.9±29.0) nmol/L；E3分别(65.5±42.3) nmol/L和(59.6±39.9)nmol/L,两组差异均无统计学意义(P＞0.05).尿失禁组血清P为(587.3±153.2) nmol/L,低于非尿失禁组(709.8±297.3) nmol/L,差异有统计学意义（P＜0.05）.尿失禁组血清松弛素H2为(5.2±3.0) nmol/L,高于非尿失禁组(3.5±1.9) nmol/L,差异有统计学意义(P=0.01).当胎儿出生体重限制在一定范围后(＜4kg),经Logistic回归分析发现只有松弛素与SUI发病相关.结论 妊娠期SUI与晚孕期血清松弛素水平正相关,与血清E2、E3无关.%Objective To study the relationship between serum concentrations of estrogen, progesterone, relaxin H2 and stress urinary incontinence (SUI) in late pregnant primipara. Methods Between Sept. 2009 and Dec. 2010, 71 late pregnant primipara who took regular prenatal examination in the out-patient department in the Sixth Affiliated Hospital of Shanghai Jiaotong University were selected. Women with SUI compose SUI group( n =33). The others were as the control group (n = 38 ). Serum samples were extracted during 36 - 40 weeks. The serum concentrations of estradiol ( E2 ), estriol (E3) . progesterone (P)were detected by immunoluminometric assay and reiaxin H2 determined by ELISA kit at department of isotope laboratory. Results The serum concentrations of E, were (89. 2 ± 28. 3) nmol/L and (88. 9 ± 29.0 ) nmol/L at the SUI group and control group respectively,there was no significant difference between two groups. The serum concentration of E, were ( 65. 5 ± 42. 3) nmol/L and (59.6 ± 39. 9 ) nmol/L respectively, there was no significant difference between two groups too. But the serum concentration of P in the SUI group was lower than that in the control group 587. 3 ± 153. 3nmol/L versus (709. 8 ±297. 3) nmol/L,P <0.05. The concentration of H2 SUI group was higher than in control group (5.2 ±3.0) nmol/L versus (3. 5 ± 1.9) nmol/L,P=0. 01. The result of binary logistic regression analysis showed that only reiaxin H2 positively correlated with SUI,but E2 ,E3 and P had no relation with it. Conclusion There was a positive relationship between SUI and reiaxin H, in late pregnant primipara, but was no relation with E2 and E3.