异氟醚分娩镇痛对母体及胎儿母体循环中cGMP水平的影响

The Effects of Isoflurane Analgesia on the Cyclic Guansosine Monophosphate Levels in maternity and Fetomaternal Circulation during Normal Labor

目的 :探讨镇痛浓度的异氟醚对母体及胎儿 -母体循环中环磷酸鸟苷 (cGMP)水平的影响。方法 :采用放射免疫测定法对异氟醚镇痛组 1 5例和对照组 1 5例的各检测标本进行测定。结果 :母体血浆中cGMP水平 ,镇痛组由实验前的 (2 .383± 0 .71 0 )pmol mL增加到实验后的 (3.0 77± 0 .938)pmol mL(P <0 .0 1 )。镇痛组脐动脉血浆中 ,cGMP水平为 (3.2 2 0± 0 .963)pmol mL明显高于对照组的 (2 .2 4 0± 0 .455)pmol mL(P <0 .0 5) ;镇痛组脐静脉血浆中 ,cGMP水平为 (3.0 73± 1 .0 2 5)pmol mL ,明显高于对照组的 (2 .1 67± 0 .372 )pmol mL(P <0 .0 1 )。镇痛组脐动脉组织中 ,cGMP水平明显高于对照组 (P <0 .0 1 )。镇痛组胎盘组织中cGMP水平明显高于对照组 (P <0 .0 1 )。结论 :母体及胎儿 -母体循环中cGMP水平增高可能是介导异氟醚血管舒张作用的重要机制之一。

Objective:To investigate the effect of isoflurane analgesia on the cyclic guanosine monophosphate(cGMP) levels in maternity and fetomaternal circulation during normal labor.Methods The analysis of cGMP levels in maternal venous blood,the umbilical venous and arteral blood,the umbilical arterial and placental tissues of 30 primiparae,15 as the Analgestic group and 15 as the Control Gruop,were performed with radioimmunoassay.Result in the Analgesic Group the cGMP level of maternal venous plasma after experiment was significantly higher than that before experiment:(3.077±0.938)vs (2.383±0.710)pmol/mL(P<0.01);there were no significant differences before and after experimen t in the Control Group(P>0.05).The cGMP levels in umbilical venous and arterial plasma were signjficantly higher in the Analgesic Gruop than those in the Control Group:(3.073±1.025)vs (2.167±0.372)pmol/mL(P<0.05) and (3.220±0.963)vs (2.460±0.455)pmol/mL(P<0.01).There were no significant differences between the cGMP levels of umbilical arterial and umbilical venous plasma in either group(P>0.05).The cGMP levels in the umbilical arterial and the placental tissues in the Analgesic Group were significnantly higher than those in the Control Group(P<0.01and P<0.01).Conclusion The rise of cGMP levels in maternity and feto-maternal circulation may be one of the important mechanisms that is involved vasodilation of isoflurane.