胎儿生长受限患者心钠素、内皮素-1浓度变化及意义
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摘要
目的:通过检测胎儿生长受限(fetal growth restriction,FGR)新生儿脐血和母亲肘静脉血中心钠素(atrial natriuretic peptide,ANP)、内皮素-1(endothelin-1,ET-1)的浓度,探讨胎儿生长受限与这两种激素的关系。
方法:采用放射免疫方法分别检测23例正常妊娠晚期孕妇的肘静脉血(对照组)及其新生儿脐静脉血ANP、ET-1浓度,23例胎儿生长受限患者的母亲肘静脉血(FGR组)及新生儿脐静脉血ANP、ET-1浓度,用SPSS13.0软件统计包处理数据并进行统计分析。
结果:(1)对照组孕妇静脉血ANP浓度为(0.12±0.04)ng/ml,FGR组孕妇静脉血ANP浓度为(0.084±0.04)ng/ml,FGR组孕妇静脉血ANP浓度低于对照组,两组比较有统计学意义(P＜0.05)。(2)对照组新生儿脐血ANP浓度(0.15±0.04)ng/ml,FGR组新生儿脐血ANP浓度为(0.12±0.05)ng/ml,FGR组脐血ANP浓度低于对照组,两者比较有统计学意义(P＜0.05)。(3)对照组孕妇静脉血ET-1浓度为(62.22±11.47)pg/ml,FGR组孕妇静脉血ET-1浓度为(65.87±8.74)pg/ml,两组比较无统计学意义(P＞0.05)。(4)对照组新生儿脐血ET-1浓度(55.70±10.45)pg/ml,FGR组新生儿脐血ET-1浓度为(75.24±8.83)pg/ml,FGR组脐血ET-1浓度高于对照组,两者比较有统计学意义(P＜0.01)。(5)对照组新生儿脐血ANP浓度高于母血ANP浓度(P＜0.05),脐血ET-1浓度低于母血ET-1浓度(P＜0.01)。(6)FGR组新生儿脐血ANP浓度高于母血ANP浓度(P＜0.05),脐血ET-1浓度高于母血ET-1浓度(P＜0.01)。(7)对照组孕妇静脉血ANP/ET-1值为(1.98±0.43),FGR组孕妇静脉血ANP/ET-1值为(1.33±0.73),FGR组孕妇ANP/ET-1值低于对照组,两组比较有统计学意义(P＜0.01)。(8)对照组新生儿脐血ANP/ET-1值为(2.62±0.43),FGR组新生儿脐血ANP/ET-1值为(1.59±0.85),FGR组脐血ANP/ET-1值低于对照组,两组比较有统计学意义(P＜0.01)。(9)对照组孕妇静脉血ANP浓度、ET-1浓度同新生儿出生体重呈正相关(r=0.459,r=0.790),新生儿脐血ANP浓度、ET-1浓度同新生儿出生体重呈正相关(r=0.608,r=0.792)。(10)FGR组孕妇静脉血及新生儿脐血ANP浓度同新生儿出生体重呈正相关(r=0.470,r=0.501),孕妇静脉血及新生儿脐血ET-1浓度同新生儿体重呈负相关(r=-0.868,r=-0.848),孕妇静脉血及新生儿脐血ANP/ET-1值与新生儿出生体重呈正相关(r=0.675,r=0.674)。
结论:ANP浓度降低、ET-1浓度升高及ANP/ET-1值降低可能是胎儿生长受限发病机制的重要环节,可以作为预测胎儿生长受限的新指标。增加子宫胎盘血流ANP的浓度及提高ANP/ET-1值可能成为预防和治疗胎儿生长受限的新途径。
Objectives:To investigate the relationship about atrial natriuretic peptide(ANP)and endothelin-1(ET-1)with fetal growth restriction,we detected the concentration of the two hormones(ANP and ET-1)in maternal elbow vein blood and umbilical vein blood from patients with fetal growth restriction.
Methods:Twenty-three normal late pregnant women and their infants(control group),twenty- three mothers of FGR and their infants were studied(FGR group).The concentration of ANP and ET-1 in maternal elbow vein blood and umbilical vein blood were determined by Radioimmunoassay(RIA).These experimental datas was analized by the software SPSS 13.0.
Results:(1)The concentration of ANP in elbow vein blood of control group was (0.12±0.04)ng/ml.The concentration of ANP in elbow vein blood of FGR group was (0.08±0.04)ng/ml,which is lower than the the concentration of controls.The difference was statistically significant(P＜0.05).(2)The concentration of ANP in umbilical vein blood of controls was(0.15±0.04)ng/ml.The concentration of ANP in umbilical vein blood of FGR group was(0.12±0.05)ng/ml,which is lower than the concentration of congtrols.The difference was statistically significant(P＜0.05).(3) The concentration of ET-1 in elbow vein blood of controls was(62.22±11.47) pg/ml,the concentration of ET-1 in elbow vein blood of FGR group was(65.87±8.74) pg/ml.There was no statistical difference between the data of two groups(P＞0.05).(4) The concentration of ET-1 in umbilical vein blood of controls was(55.70±10.45) pg/ml.The concentration of ET-1 in umbilical vein blood of FGR was(75.24±8.83) pg/ml,which is higher than the concentration of controls.The difference was statistically significant(P＜0.01).(5)In control group,the concentration of ANP in umbilical vein blood was higher than the concentration in elbow vein blood(P＜0.05),the concentration of ET-1 in umbilical vein blood was lower than the concentration in elbow vein blood(P＜0.05).(6)In FGR group,both the concentration of ANP and ET-1 in umbilical vein blood was significantly higher than the concentration in elbow vein blood(P＜0.01).(7)The ANP/ET-1 ratio in elbow vein blood of controls was(1.98±0.43).The ANP/ET-1 ratio in elbow vein blood of FGR group was(1.33±0.73),which is lower than the ratio in controls.The two groups had statistic significant difference(P＜0.01).(8)The ANP/ET-1 ratio in umbilical vein blood of controls was(2.62±0.43),the ANP/ET-1 ratio in umbilical vein blood of FGR was(1.59±0.85),which is lower than the ratio in controls.The difference was statistically significant(P＜0.01).(9)In controls,the ANP and ET-1 in elbow vein blood of controls and in umbilical vein blood were positive correlated with the birth weight of neonates(r=0.459,r=0.790,r=0.608,r=0.792).(10)In FGR,the ANP in elbow vein blood and in umbilical vein blood were positive correlated with the birth weight of neonates(r=0.470,r=0.501),the ET-1 in elbow vein blood and in umbilical vein blood were negative correlated with the birth weight of neonates(r= -0.868,r=-0.848).The ANP/ET-1 in elbow vein blood and in umbilical vein blood were positive correlated with the birth weight of neonates(r=0.675,r=0.674).
Conclution:It showed that the significantly reduced concentration of ANP and ANP/ET-1 ratio and increased concentration of ET-1 had important effect on FGR.The two hormones may be the new indicater of predicting FGR.Increasing the concentration of ANP in the uteroplacental blood flow and enlarging the ANP/ET-1 ratio,may be a new route of preventing and treating fetal growth restriction.
方法:采用放射免疫方法分别检测23例正常妊娠晚期孕妇的肘静脉血(对照组)及其新生儿脐静脉血ANP、ET-1浓度,23例胎儿生长受限患者的母亲肘静脉血(FGR组)及新生儿脐静脉血ANP、ET-1浓度,用SPSS13.0软件统计包处理数据并进行统计分析。
结果:(1)对照组孕妇静脉血ANP浓度为(0.12±0.04)ng/ml,FGR组孕妇静脉血ANP浓度为(0.084±0.04)ng/ml,FGR组孕妇静脉血ANP浓度低于对照组,两组比较有统计学意义(P＜0.05)。(2)对照组新生儿脐血ANP浓度(0.15±0.04)ng/ml,FGR组新生儿脐血ANP浓度为(0.12±0.05)ng/ml,FGR组脐血ANP浓度低于对照组,两者比较有统计学意义(P＜0.05)。(3)对照组孕妇静脉血ET-1浓度为(62.22±11.47)pg/ml,FGR组孕妇静脉血ET-1浓度为(65.87±8.74)pg/ml,两组比较无统计学意义(P＞0.05)。(4)对照组新生儿脐血ET-1浓度(55.70±10.45)pg/ml,FGR组新生儿脐血ET-1浓度为(75.24±8.83)pg/ml,FGR组脐血ET-1浓度高于对照组,两者比较有统计学意义(P＜0.01)。(5)对照组新生儿脐血ANP浓度高于母血ANP浓度(P＜0.05),脐血ET-1浓度低于母血ET-1浓度(P＜0.01)。(6)FGR组新生儿脐血ANP浓度高于母血ANP浓度(P＜0.05),脐血ET-1浓度高于母血ET-1浓度(P＜0.01)。(7)对照组孕妇静脉血ANP/ET-1值为(1.98±0.43),FGR组孕妇静脉血ANP/ET-1值为(1.33±0.73),FGR组孕妇ANP/ET-1值低于对照组,两组比较有统计学意义(P＜0.01)。(8)对照组新生儿脐血ANP/ET-1值为(2.62±0.43),FGR组新生儿脐血ANP/ET-1值为(1.59±0.85),FGR组脐血ANP/ET-1值低于对照组,两组比较有统计学意义(P＜0.01)。(9)对照组孕妇静脉血ANP浓度、ET-1浓度同新生儿出生体重呈正相关(r=0.459,r=0.790),新生儿脐血ANP浓度、ET-1浓度同新生儿出生体重呈正相关(r=0.608,r=0.792)。(10)FGR组孕妇静脉血及新生儿脐血ANP浓度同新生儿出生体重呈正相关(r=0.470,r=0.501),孕妇静脉血及新生儿脐血ET-1浓度同新生儿体重呈负相关(r=-0.868,r=-0.848),孕妇静脉血及新生儿脐血ANP/ET-1值与新生儿出生体重呈正相关(r=0.675,r=0.674)。
结论:ANP浓度降低、ET-1浓度升高及ANP/ET-1值降低可能是胎儿生长受限发病机制的重要环节,可以作为预测胎儿生长受限的新指标。增加子宫胎盘血流ANP的浓度及提高ANP/ET-1值可能成为预防和治疗胎儿生长受限的新途径。
Objectives:To investigate the relationship about atrial natriuretic peptide(ANP)and endothelin-1(ET-1)with fetal growth restriction,we detected the concentration of the two hormones(ANP and ET-1)in maternal elbow vein blood and umbilical vein blood from patients with fetal growth restriction.
Methods:Twenty-three normal late pregnant women and their infants(control group),twenty- three mothers of FGR and their infants were studied(FGR group).The concentration of ANP and ET-1 in maternal elbow vein blood and umbilical vein blood were determined by Radioimmunoassay(RIA).These experimental datas was analized by the software SPSS 13.0.
Results:(1)The concentration of ANP in elbow vein blood of control group was (0.12±0.04)ng/ml.The concentration of ANP in elbow vein blood of FGR group was (0.08±0.04)ng/ml,which is lower than the the concentration of controls.The difference was statistically significant(P＜0.05).(2)The concentration of ANP in umbilical vein blood of controls was(0.15±0.04)ng/ml.The concentration of ANP in umbilical vein blood of FGR group was(0.12±0.05)ng/ml,which is lower than the concentration of congtrols.The difference was statistically significant(P＜0.05).(3) The concentration of ET-1 in elbow vein blood of controls was(62.22±11.47) pg/ml,the concentration of ET-1 in elbow vein blood of FGR group was(65.87±8.74) pg/ml.There was no statistical difference between the data of two groups(P＞0.05).(4) The concentration of ET-1 in umbilical vein blood of controls was(55.70±10.45) pg/ml.The concentration of ET-1 in umbilical vein blood of FGR was(75.24±8.83) pg/ml,which is higher than the concentration of controls.The difference was statistically significant(P＜0.01).(5)In control group,the concentration of ANP in umbilical vein blood was higher than the concentration in elbow vein blood(P＜0.05),the concentration of ET-1 in umbilical vein blood was lower than the concentration in elbow vein blood(P＜0.05).(6)In FGR group,both the concentration of ANP and ET-1 in umbilical vein blood was significantly higher than the concentration in elbow vein blood(P＜0.01).(7)The ANP/ET-1 ratio in elbow vein blood of controls was(1.98±0.43).The ANP/ET-1 ratio in elbow vein blood of FGR group was(1.33±0.73),which is lower than the ratio in controls.The two groups had statistic significant difference(P＜0.01).(8)The ANP/ET-1 ratio in umbilical vein blood of controls was(2.62±0.43),the ANP/ET-1 ratio in umbilical vein blood of FGR was(1.59±0.85),which is lower than the ratio in controls.The difference was statistically significant(P＜0.01).(9)In controls,the ANP and ET-1 in elbow vein blood of controls and in umbilical vein blood were positive correlated with the birth weight of neonates(r=0.459,r=0.790,r=0.608,r=0.792).(10)In FGR,the ANP in elbow vein blood and in umbilical vein blood were positive correlated with the birth weight of neonates(r=0.470,r=0.501),the ET-1 in elbow vein blood and in umbilical vein blood were negative correlated with the birth weight of neonates(r= -0.868,r=-0.848).The ANP/ET-1 in elbow vein blood and in umbilical vein blood were positive correlated with the birth weight of neonates(r=0.675,r=0.674).
Conclution:It showed that the significantly reduced concentration of ANP and ANP/ET-1 ratio and increased concentration of ET-1 had important effect on FGR.The two hormones may be the new indicater of predicting FGR.Increasing the concentration of ANP in the uteroplacental blood flow and enlarging the ANP/ET-1 ratio,may be a new route of preventing and treating fetal growth restriction.
引文
[1]乐杰主编.妇产科学,第6版.北京:人民卫生出版社,2006.137-139
[2]F.Gary Cunningham主编.郎景和主译.威廉姆斯产科学(第20版).北京:世界图书出版公司,2001,880-881
[3]Alan HD,Lauren N,主编.刘新民,宋玉琴,万小平等主译.现代妇产科疾病诊断与治疗(第2版).北京:人民卫出版社,2004,240-246
[4]喻玲,赖徽斯,丁依玲.常见妊娠并发症的营养指导.中国实用妇科与产科杂志.2007,23,(4):252-254
[5]范利,方芳,叶文珏.正常妊娠和妊高征孕妇血浆内皮素、血栓素、前列环素、心钠素含量测定及意义.中国实用妇科与产科杂志.2000,16,(8):477-480
[6]曹泽毅 主编.中华妇产科学.第2版.北京:人民卫生出版社,2005.209-214
[7]张永学.实验核医学.北京:人民军医出版社,2002;9
[8]张艳萍,叶卫莲,郑巧莎.胎儿宫内发育迟缓患者胎盘血管内皮生长因子的变化及其意义.中国妇幼保僻,2005,20(1):66-67
[9]Makikallio K,Vuolteenaho O,Jouppila P,et al.Umbilical Artery N-Terminal Peptide of Proatrial Natriuretic Peptide in Hypertensive Pregnancies and Fetal Acidemia During Labor[J].Obstetrics and Gynecology.2001,(97),1:23-28
[10]Makikallio K,Vuolteenaho O,Jouppila P,et al.Ultrasonographic and Biochemical Markers of Human Fetal Cardiac Dysfunction in Placental Insufficiency[J].Circulation 2002,105:2058-2063
[11]Battistal MC,Calvo E,Chorvatova A,et al.Intra-uterine growth restriction and the programming of left ventricular remodelling in female rats[J].Physiol.2005,565:197-205.
[12]Maggioni C,Lucini D,Antinozzi R,et al.Circadian rhythm of ANP aldosterone and PRA in normotensive IUGR[J].Hypertens.2001;19(9):1659-1664.
[13]杨永秀,张登霞,胡俊萍.胎儿宫内发育迟缓时孕妇及胎儿心钠素的变化及意义.实用妇产科杂志,2002,18(3):163
[14]Walther T,Stepan H,Pankow K,et al.Relation of ANP and BNP to their N-terminal fiagments in fetal circulation:evidence for enhanced neutral endopeptidase activity and resistance of BNP to neutral endopeptidase in the fetus[J].Obstetrics and Gynaecology.2004, 111: 452-4558.
[15] Troughton RW,Frampton CM,Yandle TG,et al.Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations[J].Lancet 2000;355:l 126-1130
[16] Yanagisawa M, Kurihara H, Kimura S, et al. A novel vasoconstrictor peptide produced by vascular endothelial cells. Nature, 1988,332:411-415.
[17] Bacon CR, Morrison JJ, O' ReillyG, et al. ET-Aand ET-B endothelin receptors in humanmyometrium characterized bythe subtype selective ligands BQ 123, BQ 3020, FR 139317 and PD 141242. J Endo--crinol, 1995,144:127-134.
[18] Levin ER. Endothelins. N Engl J Med, 1995,333:356-363.
[19] JauniauxE, MignotTM, Rebourcet R, et al. Placental endothelin geneexpression and endothelin concentration in fetal fluids of the first trimestergestational sac. Mol Hum Reprod, 2000,6:758-762.
[20] Dotsch J, HogenN, Nyul Z, et al. Increase of endothelial nitric oxide synthase and endothelin-1 mRNA expression in human placenta during estation. Eur J Obstet Gynecol Reprod Biol, 2001,97:163-167.
[21] Peri A, Vannelli GB, Fantoni G, et al. Endothelin in rabbit uterus during pregnancy. Am J Physiol, 1992,263:158-167.
[22] Iwata I, Takagi T, Yamaji K, et al. Increase in the concentration of immunoreactive endothelin in human pregnancy. J Endocrinol, 1991,129: 301-307.
[23] Hakkinen LM, Vuolteenaho OJ, Leppaluoto JP, et al. Endothelin in maternal and umbilical cord blood in spontaneous labor and at elective cesarean delivery. Obstet. Gynecol, 1992, 80:72-75.
[24] Usuki S, SaitohT, SawamuraT, et al. Increasedmaternal plasma concentration of endothelin-1 during labor pain or on delivery and the existence of a large amount of endothelin-1 in amniotic fluid. Gynecol Endocrinol, 1990,4: 85-97.
[25] Dallot E, Pouchelet M, Gouhier N, et al. Contraction of Cultured Human Uterine Smooth Muscle Cells after Stimulation with Endothelin-1. Biology of Reproduction. 2003,68:937-942.
[26] Kimura A, Ohmichi M, Takeda T, et al. Mitogen-Activated Protein Kinase Cascade Is Involved in Endothelin-1-Induced Rat Puerperal Uterine Contraction. Endocrinology, 1999,140: 722-731.
[27] Mcqueen J, Kingdom JC, Connell JM, et al. Fetal endothelin levels and placental vascular endothelin receptors in intrauterine growth retardation.Obstet.Gynecol,1993,82:992-998.
[28]Schiff E,Weiner E,Zalel Y,et al.Endothelin-1,2 levels in umbilical vein serumof intra-uterine growth retarded fetuses as detected by cordocentesis.Acta Obstet Gynecol Scand,1994,73:21-24.
[29]Wolff K,Nisell H,Carlstrom K,et al.Endothelin-1 and big endothelin-1 levels in normal term pregnancy and in preeclampsia.Regulatory Peptides,1996,67:211-216.
[30]ErdemM,Erdem A,Erdem O,et al.Immunohistochemical localization of endothelin-1 in human placenta from normal and growth restricted pregnancies.Pediatr Dev Pathol,2003,6:307-313.
[31]高树生,陈竹钦.妊娠晚期内皮素及心钠素与新生儿体重关系的探讨.中国优生与遗传,1999,7:70-71.
[32]沈卓娜,周小玲,黄瑾.内皮素-1在不同类型胎儿生长受限胎盘绒毛组织的表达.中国实用妇科与产科杂志.2006,3,(23):39-40
[33]李新琳,杨瑛,杨梦庚,等.人心钠素对妊高征静脉血一氧化氮及内皮素水平的影响.中国优生与遗传杂志,2000,(8),5:22-23
[34]Irons DW,Baylis PH,Davison JM.Effects of atrial natriuretic peptide on renal hemodynamics and sodium excretion during human pregnancy.Am J Physiol,1996:271(1):239-242
[1]曹泽毅 主编.中华妇产科学.第2版.北京:人民卫生出版社,2005.209-214
[2]Makikallio K,Vuolteenaho O,Jouppila P,et al.Umbilical Artery N-Terminal Peptide of Proatrial Natriuretic Peptide in Hypertensive Pregnancies and Fetal Acidemia During Labor[J].Obstetrics and Gyn ecology.2001,(97),1:23-28
[3]Makikallio K,Vuolteenaho O,Jouppila P,et al.Ultrasonographic and Biochemical Markers of Human Fetal Cardiac Dysfunction in Placental Insufficiency[J].Circulation 2002,105:2058-2063
[4]Battistal MC,Calvo E,Chorvatova A,et al.Intra-uterine growth restriction and the programming of left ventricular remodelling in female rats[J].Physiol.2005,565:197-205.
[5]Walther T,Stepan H,Pankow K,et al.Relation of ANP and BNP to their N-terminal fragments in fetal circulation:evidence for enhanced neutral endopeptidase activity and resistance of BNP to neutral endopeptidase in the fetus[J].Obstetrics and Qynaecology.2004,111:452-4558.
[6]Troughton RW,Frampton CM,Yandle YG,et al.Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide(N-BNP)concentrations[J].Lancet 2000;355:1126-1130
[7]Horio T,Nishikimi T,Yoshihara F,et al.Inhibitory regulation of hypertrophy by endogenous atrial natriuretic peptide in cultured cardiac myocytes[J].Hypertension 2000;35:19-24
[8]范利,方芳,叶文珏,正常妊娠和妊高征孕妇血浆内皮素、血栓素、前列环素、心钠素含量测定及意义.中国实用妇科与产科杂志.2000,16,(8):477-480
[9]乐杰 主编.妇产科学,第6版.北京:人民卫生出版社,2006.137-139
[10]喻玲,赖徽斯,丁依玲.常见妊娠并发症的营养指导.中国实用妇科与产科杂志.2007,23,(4):252-254
[11]Walther T,Stepan H,Faber R.Dual natriuretic peptide response to volume load in the fetal circulation.Cardiovasc Res.2001;49(4):817-819
[12]Yamada J,Fujimori K,lshida T,et al.Plasma endothelin-1 and atrial natriuretic peptide levels during prolonged(24-h)non-acidemic hypoxemia in fetal goats[J].Matern Fetal Meal.2001;10(6):409-413.,
[13]Hohimer AR,Mysliwiec M,Lee K,et al.Perinatal hypoxia causes ventricular enlargement associated with increased atrial natriuretic peptide(ANP)mRNA levels in newborn mice[J].2003:4(2):241-254..
[14]Maggioni C,Lucini D,Antinozzi R,et al.Circadian rhythm of ANP,aldosterone and PRA in normotensive IUGR[J].Hypertens.2001;19(9):1659-1664.
[15]杨永秀,张登霞,胡俊萍.胎儿宫内发育迟缓时孕妇及胎儿心钠素的变化及意义.实用妇产科杂志,2002,18(3):163
[16]Stepan H,Walther D,Faber R,et al.Detection of C-type peptide in fetal cieculation[J].Perinat Med.2000;28:118-121
[17]李新琳,杨瑛,杨梦庚,等.人心钠素对妊高征静脉血一氧化氮及内皮素水平的影响.中国优生与遗传杂志,2000,(8),5:22-23
[2]F.Gary Cunningham主编.郎景和主译.威廉姆斯产科学(第20版).北京:世界图书出版公司,2001,880-881
[3]Alan HD,Lauren N,主编.刘新民,宋玉琴,万小平等主译.现代妇产科疾病诊断与治疗(第2版).北京:人民卫出版社,2004,240-246
[4]喻玲,赖徽斯,丁依玲.常见妊娠并发症的营养指导.中国实用妇科与产科杂志.2007,23,(4):252-254
[5]范利,方芳,叶文珏.正常妊娠和妊高征孕妇血浆内皮素、血栓素、前列环素、心钠素含量测定及意义.中国实用妇科与产科杂志.2000,16,(8):477-480
[6]曹泽毅 主编.中华妇产科学.第2版.北京:人民卫生出版社,2005.209-214
[7]张永学.实验核医学.北京:人民军医出版社,2002;9
[8]张艳萍,叶卫莲,郑巧莎.胎儿宫内发育迟缓患者胎盘血管内皮生长因子的变化及其意义.中国妇幼保僻,2005,20(1):66-67
[9]Makikallio K,Vuolteenaho O,Jouppila P,et al.Umbilical Artery N-Terminal Peptide of Proatrial Natriuretic Peptide in Hypertensive Pregnancies and Fetal Acidemia During Labor[J].Obstetrics and Gynecology.2001,(97),1:23-28
[10]Makikallio K,Vuolteenaho O,Jouppila P,et al.Ultrasonographic and Biochemical Markers of Human Fetal Cardiac Dysfunction in Placental Insufficiency[J].Circulation 2002,105:2058-2063
[11]Battistal MC,Calvo E,Chorvatova A,et al.Intra-uterine growth restriction and the programming of left ventricular remodelling in female rats[J].Physiol.2005,565:197-205.
[12]Maggioni C,Lucini D,Antinozzi R,et al.Circadian rhythm of ANP aldosterone and PRA in normotensive IUGR[J].Hypertens.2001;19(9):1659-1664.
[13]杨永秀,张登霞,胡俊萍.胎儿宫内发育迟缓时孕妇及胎儿心钠素的变化及意义.实用妇产科杂志,2002,18(3):163
[14]Walther T,Stepan H,Pankow K,et al.Relation of ANP and BNP to their N-terminal fiagments in fetal circulation:evidence for enhanced neutral endopeptidase activity and resistance of BNP to neutral endopeptidase in the fetus[J].Obstetrics and Gynaecology.2004, 111: 452-4558.
[15] Troughton RW,Frampton CM,Yandle TG,et al.Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations[J].Lancet 2000;355:l 126-1130
[16] Yanagisawa M, Kurihara H, Kimura S, et al. A novel vasoconstrictor peptide produced by vascular endothelial cells. Nature, 1988,332:411-415.
[17] Bacon CR, Morrison JJ, O' ReillyG, et al. ET-Aand ET-B endothelin receptors in humanmyometrium characterized bythe subtype selective ligands BQ 123, BQ 3020, FR 139317 and PD 141242. J Endo--crinol, 1995,144:127-134.
[18] Levin ER. Endothelins. N Engl J Med, 1995,333:356-363.
[19] JauniauxE, MignotTM, Rebourcet R, et al. Placental endothelin geneexpression and endothelin concentration in fetal fluids of the first trimestergestational sac. Mol Hum Reprod, 2000,6:758-762.
[20] Dotsch J, HogenN, Nyul Z, et al. Increase of endothelial nitric oxide synthase and endothelin-1 mRNA expression in human placenta during estation. Eur J Obstet Gynecol Reprod Biol, 2001,97:163-167.
[21] Peri A, Vannelli GB, Fantoni G, et al. Endothelin in rabbit uterus during pregnancy. Am J Physiol, 1992,263:158-167.
[22] Iwata I, Takagi T, Yamaji K, et al. Increase in the concentration of immunoreactive endothelin in human pregnancy. J Endocrinol, 1991,129: 301-307.
[23] Hakkinen LM, Vuolteenaho OJ, Leppaluoto JP, et al. Endothelin in maternal and umbilical cord blood in spontaneous labor and at elective cesarean delivery. Obstet. Gynecol, 1992, 80:72-75.
[24] Usuki S, SaitohT, SawamuraT, et al. Increasedmaternal plasma concentration of endothelin-1 during labor pain or on delivery and the existence of a large amount of endothelin-1 in amniotic fluid. Gynecol Endocrinol, 1990,4: 85-97.
[25] Dallot E, Pouchelet M, Gouhier N, et al. Contraction of Cultured Human Uterine Smooth Muscle Cells after Stimulation with Endothelin-1. Biology of Reproduction. 2003,68:937-942.
[26] Kimura A, Ohmichi M, Takeda T, et al. Mitogen-Activated Protein Kinase Cascade Is Involved in Endothelin-1-Induced Rat Puerperal Uterine Contraction. Endocrinology, 1999,140: 722-731.
[27] Mcqueen J, Kingdom JC, Connell JM, et al. Fetal endothelin levels and placental vascular endothelin receptors in intrauterine growth retardation.Obstet.Gynecol,1993,82:992-998.
[28]Schiff E,Weiner E,Zalel Y,et al.Endothelin-1,2 levels in umbilical vein serumof intra-uterine growth retarded fetuses as detected by cordocentesis.Acta Obstet Gynecol Scand,1994,73:21-24.
[29]Wolff K,Nisell H,Carlstrom K,et al.Endothelin-1 and big endothelin-1 levels in normal term pregnancy and in preeclampsia.Regulatory Peptides,1996,67:211-216.
[30]ErdemM,Erdem A,Erdem O,et al.Immunohistochemical localization of endothelin-1 in human placenta from normal and growth restricted pregnancies.Pediatr Dev Pathol,2003,6:307-313.
[31]高树生,陈竹钦.妊娠晚期内皮素及心钠素与新生儿体重关系的探讨.中国优生与遗传,1999,7:70-71.
[32]沈卓娜,周小玲,黄瑾.内皮素-1在不同类型胎儿生长受限胎盘绒毛组织的表达.中国实用妇科与产科杂志.2006,3,(23):39-40
[33]李新琳,杨瑛,杨梦庚,等.人心钠素对妊高征静脉血一氧化氮及内皮素水平的影响.中国优生与遗传杂志,2000,(8),5:22-23
[34]Irons DW,Baylis PH,Davison JM.Effects of atrial natriuretic peptide on renal hemodynamics and sodium excretion during human pregnancy.Am J Physiol,1996:271(1):239-242
[1]曹泽毅 主编.中华妇产科学.第2版.北京:人民卫生出版社,2005.209-214
[2]Makikallio K,Vuolteenaho O,Jouppila P,et al.Umbilical Artery N-Terminal Peptide of Proatrial Natriuretic Peptide in Hypertensive Pregnancies and Fetal Acidemia During Labor[J].Obstetrics and Gyn ecology.2001,(97),1:23-28
[3]Makikallio K,Vuolteenaho O,Jouppila P,et al.Ultrasonographic and Biochemical Markers of Human Fetal Cardiac Dysfunction in Placental Insufficiency[J].Circulation 2002,105:2058-2063
[4]Battistal MC,Calvo E,Chorvatova A,et al.Intra-uterine growth restriction and the programming of left ventricular remodelling in female rats[J].Physiol.2005,565:197-205.
[5]Walther T,Stepan H,Pankow K,et al.Relation of ANP and BNP to their N-terminal fragments in fetal circulation:evidence for enhanced neutral endopeptidase activity and resistance of BNP to neutral endopeptidase in the fetus[J].Obstetrics and Qynaecology.2004,111:452-4558.
[6]Troughton RW,Frampton CM,Yandle YG,et al.Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide(N-BNP)concentrations[J].Lancet 2000;355:1126-1130
[7]Horio T,Nishikimi T,Yoshihara F,et al.Inhibitory regulation of hypertrophy by endogenous atrial natriuretic peptide in cultured cardiac myocytes[J].Hypertension 2000;35:19-24
[8]范利,方芳,叶文珏,正常妊娠和妊高征孕妇血浆内皮素、血栓素、前列环素、心钠素含量测定及意义.中国实用妇科与产科杂志.2000,16,(8):477-480
[9]乐杰 主编.妇产科学,第6版.北京:人民卫生出版社,2006.137-139
[10]喻玲,赖徽斯,丁依玲.常见妊娠并发症的营养指导.中国实用妇科与产科杂志.2007,23,(4):252-254
[11]Walther T,Stepan H,Faber R.Dual natriuretic peptide response to volume load in the fetal circulation.Cardiovasc Res.2001;49(4):817-819
[12]Yamada J,Fujimori K,lshida T,et al.Plasma endothelin-1 and atrial natriuretic peptide levels during prolonged(24-h)non-acidemic hypoxemia in fetal goats[J].Matern Fetal Meal.2001;10(6):409-413.,
[13]Hohimer AR,Mysliwiec M,Lee K,et al.Perinatal hypoxia causes ventricular enlargement associated with increased atrial natriuretic peptide(ANP)mRNA levels in newborn mice[J].2003:4(2):241-254..
[14]Maggioni C,Lucini D,Antinozzi R,et al.Circadian rhythm of ANP,aldosterone and PRA in normotensive IUGR[J].Hypertens.2001;19(9):1659-1664.
[15]杨永秀,张登霞,胡俊萍.胎儿宫内发育迟缓时孕妇及胎儿心钠素的变化及意义.实用妇产科杂志,2002,18(3):163
[16]Stepan H,Walther D,Faber R,et al.Detection of C-type peptide in fetal cieculation[J].Perinat Med.2000;28:118-121
[17]李新琳,杨瑛,杨梦庚,等.人心钠素对妊高征静脉血一氧化氮及内皮素水平的影响.中国优生与遗传杂志,2000,(8),5:22-23