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目的探讨胎膜早破孕妇应用地塞米松、黄体酮对外周血CRH及分娩时间的影响。方法 60例胎膜早破的孕妇随机分为4组,分别应用地塞米松、地塞米松+黄体酮、黄体酮及不用药物处理。记录孕妇于入院时、入院后24h、48h的CRH值、分娩时间及新生儿体重。结果四组孕妇刚入院时的外周血CRH水平比较差异无统计学意义(P>0.05);入院后24h、48h比较差异均有统计学意义(P<0.05);地塞米松组CRH显著高于另外3组(P<0.05);入院后24h,地塞米松+黄体酮组、黄体酮组、对照组外周血CRH水平无差异(P>0.05)。入院后48h,地塞米松+黄体酮组、黄体酮组分别与对照组比较有差异(P<0.05)。组内比较,地塞米松组CRH水平随时间增加显著升高(P<0.05);地塞米松+黄体酮组与黄体酮组CRH水平无变化(P>0.05);对照组直至入院后48h CRH才显著升高(P<0.05)。地塞米松组的分娩时间明显短于其他三组(P<0.05);其他三组分娩时间比较差异无统计学意义(P>0.05)。四组新生儿体重比较差异无统计学意义(P>0.05)。孕妇外周血CRH与分娩时间呈负相关(r=-0.89,P<0.05)。结论地塞米松可促进胎膜早破孕妇的分娩发动,黄体酮则可拮抗地塞米松的作用。
Objective To investigate the effects of dexamethasone and progesterone on CRH and delivery time in pregnant women with premature rupture of membranes. Methods Sixty pregnant women with premature rupture of membranes were randomly divided into 4 groups and treated with dexamethasone, dexamethasone + progesterone, progesterone and no drug. Record the CRH value of pregnant women at admission, 24h, 48h after admission, delivery time and neonatal weight. Results There was no significant difference in CRH level between the four groups of pregnant women just after admission (P> 0.05). The difference was significant at 24 and 48 hours after admission (P <0.05). CRH in dexamethasone group was significantly higher than that in dexamethasone group (P <0.05). There was no difference in CRH levels in dexamethasone + progesterone group, progesterone group and control group at 24 h after admission (P> 0.05). 48h after admission, dexamethasone + progesterone group and progesterone group were significantly different from the control group (P <0.05). The levels of CRH in dexamethasone group increased significantly with time (P <0.05), while the levels of CRH in dexamethasone + progesterone group and progesterone group did not change (P> 0.05). In the control group, CRH Was significantly higher (P <0.05). Delivery time in dexamethasone group was significantly shorter than that in the other three groups (P <0.05). There was no significant difference in delivery time among the other three groups (P> 0.05). Four groups of newborns weight difference was not statistically significant (P> 0.05). The level of CRH in pregnant women was negatively correlated with childbirth time (r = -0.89, P <0.05). Conclusion Dexamethasone can promote the birth of premature rupture of membranes and progesterone can antagonize the effect of dexamethasone.