分娩镇痛对孕产妇血清补体C_3、C_4及C反应蛋白的影响

Effect of labor analgesia on serum complement C_3,C_4 and C-reactive protein

目的评价分娩镇痛对产妇血清补体C3、C4及C反应蛋白(CRP)的影响。方法选择体质指数(BMI)18~24kg/m^2、妊娠38~41周单胎足月初产妇60例,采用随机数字表法分为镇痛组(30例)和对照组(30例)。镇痛组孕妇宫口开大≥3cm时硬膜外麻醉镇痛,对照组不采用任何镇痛措施。采用免疫速率散射比浊法测定孕妇进入产程时、宫口开大3cm、产后24h、产后48h血清补体C_3、C_4和CRP水平。结果 1镇痛组产后24h补体C_3、C_4分别为(1.02±0.01)g/L和(0.22±0.01)g/L,与进入产程时补体C_3、C_4[(1.41±0.01)g/L、(0.33±0.03)g/L]比较,差异有统计学意义(P<0.05)。镇痛组产后48h补体C_3、C_4分别为(1.33±0.02)g/L、(0.30±0.01)g/L,与产后24h比较,差异有统计学意义(P<0.05)。对照组产后24h补体C3、C4分别为(0.86±0.03)g/L和(0.19±0.01)g/L,与进入产程时[(1.47±0.05)g/L、(0.31±0.01)g/L]比较,差异有统计学意义(P<0.05)。两组产后48h补体C3、C4比较,差异有统计学意义(P<0.05)。2镇痛组产后24hCRP水平[(44.52±11.62)g/L],与进入产程时[(6.78±1.60)g/L]比较,差异有统计学意义(P<0.05);镇痛组产后48hCRP水平为(21.09±11.81)g/L,与对照组(33.22±11.82)g/L比较,差异有统计学意义(P<0.05)。结论硬膜外中麻醉镇痛能减轻应激反应造成的CRP增高,但补体系统无明显改变。

Objective To evaluate labor analgesia on maternal serum complement C_3、C_4 and C-reactive protein（CRP）.Methods 60 patients with Body mass index（BMI） in 18-24,38 to 41 weeks of pregnancy,singletons full-term primipara recruited in the study.They were divided into two groups by random number table（n=30）：epidural analgesia group and the control group.Start analgesia when pregnant cervix ≥3 cm（epidural analgesia group）,the control group did not use any anesthesia.Serum complement C_3、C_4 and CRP content were measured by immune rate nephelometry assay at get into the labor（T1）,cervix 3 cm（T2）,postpartum 24 h（T3） and postpartum 48 h（T4）.Results Levels of C_3、C_4 24 h postpartum in analgesia group[（1.02±0.01） g/L and（0.22±0.01） g/L ] were decreased compared to that before labor[（1.41±0.01） g/L,（0.33±0.03） g/L],the difference was statistically significant（P〈0.05）.The levels of C_3 and C_4 in 48 h postpartum（1.33±0.02） g/L,（0.30±0.01） g/L and 24 h postpartum was significant different（P〈0.05）.In control group,levels of C_3,C_4[（0.86±0.03） g/L,（0.19±0.01） g/L]24 h postpartum were significant lower than that of before labor[（1.47±0.05） g/L,（0.31±0.01） g/L]（P〈0.05）.Similarly results was found between 48 h postpartum group and control group（P〈0.05）.CRP level（44.52±11.62） g/L in 24 h postpartum analgesia group,was significant higher than that before labor（6.78±1.60） g/L（P〈0.05）.CRP level（21.09±11.81） g/L in 48 h postpartum analgesia group was lower than control group[（33.22±11.82） g/L]（P〈0.05）.Conclusion Epidural anesthesia analgesic can reduce the stress reaction caused by increased c-reactive protein and maintain the stability of the complement system.