镇痛分娩对产妇红细胞免疫黏附功能及其调节因子的影响

Effects of Analgesia Laboring on Parturients' Erythrocyte Immunity and It's Modulatory Factors

目的 :研究镇痛分娩对产妇红细胞免疫黏附功能及其调节因子的影响。方法 :选择足月期望经阴道分娩的单胎头先露初产妇 90例 ,随机分为镇痛分娩组 (A)和非镇痛分娩组 (N) ,分别在产前、宫口 3cm、胎儿娩出、产后 2 4h、产后 4 8h采静脉血 ,检测红细胞酵母菌花环率 (RYRR)、红细胞免疫复合物花环率 (RICRR)、肿瘤细胞红细胞花环率 (TRRR)、红细胞免疫黏附促进率 (RFER)、红细胞免疫黏附抑制率 (RFIR)。去除剖宫产分娩及产钳助产分娩 ,成功阴道分娩A组及N组各 18例。结果 :产前及宫口 3cm时各检测值无明显变化 ,组间无显著差异 (P >0 .0 5 ) ;胎儿娩出时两组RYRR、TRRR、RFER明显下降 (P <0 .0 5 ,P <0 .0 1) ,RICRR、RFIR明显增加 (P <0 .0 5 ,P <0 .0 1) ,但组间无显著差异 (P >0 .0 5 ) ;产后 2 4h ,A组各指标已基本恢复至基础值 ,两组组间差异显著 (P <0 .0 5 ,P <0 .0 1) ;产后 4 8h两组各指标恢复至产前水平。结论 :镇痛分娩能显著改善分娩疼痛应激对产妇红细胞免疫黏附功能及其调节因子的影响。

Objective: To study the effects of analgesia laboring on parturients' erythrocyte immunity and it's modulatory factors. Methods: Ninety nulliparous women with term singleton gestation who attempted vaginal delivery were enrolled and allocated randomly into analgesia labor group(A) and normal labor group(N),group A were performed patient-controlled epidural analgesia using the 0.0002%fentanyl mixed with 0.075% bupivacaine,venous blood samples were taken antepartum, 3 cm of cervical dilatation, parturition ,post-partum 24h and post-partum 48h for measuring red blood cells-yeast cells rosette rate(RYRR),the red blood cells-tumur cells rosette rate(TRRR),the red blood cells-immune complex rosette rate(RICR),the rosette forming enhancing rate(RFER), the rosette forming inhibitory RATE(RFIR).Eighteeen primiparases each in two groups successfully delivery transvaginally. Results:There was no significant difference between antepartum and 3cm cervical dilation in both groups (P>0.05).RYRR,TRRR and RFER decreased,while RICRR and RFIR increased dramatically at parturition in A and at parturition, 24h following parturition in N(P<0.05, P<0.01),respectively. There was significant difference between two groups with regard to the monitored values 24h following parturition. Conclusion: Analgesia Laboring via continous epidural administration can alleviate pain stress induced by parturition and protect effectively parturients' erythrocyte immunity and it's adjusting factors.