腰段连续硬膜外阻滞对妊娠期高血压疾病大鼠IL-10、TNF-α的影响

Effect of continuous lumbar epidural block on interleukin-10 and tumor necrosis factor-α in rats with hyper-tensive disorder complicating pregnancy

目的:探讨腰段连续硬膜外神经阻滞对妊娠期高血压疾病防治作用的免疫学机制。方法:参照OLSON等介绍的方法复制妊娠期高血压疾病大鼠模型。实验动物分为4组:对照组(A组)孕鼠从妊娠14 d起每日皮下注射0.5 ml生理盐水;实验组(B组)孕鼠从妊娠14 d起每日皮下注射L-NAME 50 mg;假手术组(C组)孕鼠从妊娠14 d起行硬膜外腔置管术,但不给药;治疗组(D组)孕鼠从妊娠14 d起行硬膜外腔置管术,每日注入0.125%Bupivacaine 25 lμ。双抗体夹心法观察腰段连续硬膜外神经阻滞后妊娠期高血压疾病大鼠胎盘、子宫组织白细胞介素10(IL-10)、肿瘤坏死因子(αTNF-α)含量的变化。结果:IL-10含量,B、C组较A、D组明显降低(P<0.05),A与D组、B与C组相比无显著性差异。TNF-α含量,B、C组较A、D组明显增高(P<0.05),A与D组、B与C组相比无显著性差异。结论:腰段连续硬膜外神经阻滞减少妊娠期高血压疾病大鼠TNF-α的含量,增加IL-10的含量,可能是其对妊娠期高血压疾病具有防治作用的机制之一。

Objective： To explore the effect of continuous lumbar epidural block in rats with hypertensive disorder complicating pregnancy and the immunological mechanism. Methods： The rat model of hypertensive disorder complicating pregnancy was established according to Olson＇s method. The rats were divided into 4 groups： control group（group A）, experimental group （group B）, sham operation group（group C ）, and treatment group （group D）. The rats were injected with 0.5 ml saline subcutaneously in group A, 50 mg L-NAME subcutaneously in group B, and 25 μl Bupivacaine epidurally in group D since day 14 of gestation. The rats in group C received no drug. The contents of interleukin-10 （IL-10） and tumor necrosis factor-α （TNF-α） in the placenta and uterus were determined, Results： The contents of IL-10 in groups B and C were significantly lower than those in groups A and D （P 〈 0.05 ）. The contents of TNF-α in groups B and C were significandy higher than those in groups A and D （P 〈 0.05）. No significant difference in the contents of IL-10 and TNF-α was found both between group A and group D and between group B and group C. Conclusion： The continuous lumbar epidural blockade can decrease TNF-α content α increase IL-10 content in the placenta and uterus of rats with hypertensive disorder complicating pregnancy, which may be involved in the mechanism of its preventive effect in hypertensive disorder complicating pregnancy.