胎羊宫内心脏介入手术后孕羊早产相关因素分析

Assessment of Related Factors Regarding Premature Delivery of Pregnant Ewes after Intrauterine Fetal Cardiac Intervention

目的研究胎羊宫内心脏介入手术后孕羊早产相关因素。方法对8只怀孕波尔山羊实施胎羊宫内心脏介入手术。术中监测孕羊心率、血糖、血压及血气值，于术前、术后即刻及术后48h分别检测孕羊血浆雌二醇（E2）、孕酮（P）、儿茶酚胺、白细胞介素等指标并进行比较。结果胎羊宫内心脏介入手术过程中孕羊心率、血压及血气值稳定，血糖略有增高。手术结束时刻孕羊血E2、E2／P、儿茶酚胺水平较术前增高俨〈0．05）；术后48h，足月产组孕羊血E2、E2／P基本恢复至术前水平，早产组孕羊血E2仍水平持续在较高水平。孕羊血白细胞介素．6在手术结束时点较术前增高俨〈0．05）；术后48h，足月产组孕羊血白细胞介紊6明显下降，早产组孕羊血白细胞介素．6水平无明显降低。结论胎羊宫内心脏介入术中孕羊雌孕激素、儿茶酚胺、炎性细胞因子等指标的变化可能是术后孕羊早产的相关因素。

Objective To explore the related factors of premature delivery of pregnant ewes after intrauterine fetal cardiac intervention. Methods Eight bigeminal pregnant ewes （between 101 to 127 d of the gestation） were undergone intrauterine fetal cardiac intervention. The heart rate, blood pressure, blood gas value and glucose levels of the ewes were monitored during the procedure. The levels of estradiol, progesterone, catecholamine and interleukins of the ewes were compared before surgery, right after surgery and 48 hours post-surgery. Results There were no significant changes on the heart rate, blood pressure and blood gas value during and after surgery, the blood glucose levels slightly increased. The level of estradiol, progesterone and catecholamine demonstrated with significantly increasing after surgery（P〈0.05）. Fourty-eight hours aftersurgery, the values of Estradiol, Estradiol/progesterone recovered to the same level as that before surgery in mature delivery group, while in premature delivery group, Estradiol value remained in a high level. Interleukin-6 level significantly increased just after surgery （P〈0.05）. 48 hours after surgery, Interleukin-6 level decreased significantly in mature delivery group （P〈0.05）while it maintained in a high level in premature delivery group. Conclusion The changes of estradiol, progesterone, catecholamine and interleukin-6 could be the related factors that affect the premature delivery of pregnant ewes after intrauterine fetal cardiac intervention.