经阴道分娩产妇血浆IL-6水平变化及影响因素分析  

Changes of plasma IL-6 levels and its influencing factors in parturients with vaginal delivery

作　　者：刘琴 孙彩霞 陈晨 张进[1] 任树君 LIU Qin;SUN Cai-xia;CHEN Chen(Department of Anesthesiology,Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212001,China;Department of Anesthesiology,People's Hospital of Jiangsu University,Zhenjiang Jiangsu 212002,China)

机构地区：[1]江苏大学附属医院麻醉科,江苏镇江212001 [2]江苏大学附属人民医院麻醉科,江苏镇江212002

出　　处：《临床和实验医学杂志》2022年第13期1422-1426,共5页Journal of Clinical and Experimental Medicine

基　　金：江苏省中医药科技发展计划项目(编号:MS2021083)。

摘　　要：目的探讨经阴道分娩产妇血浆白细胞介素(IL)-6水平的变化及其影响因素。方法对2020年6月至2021年6月在江苏大学附属医院产科经阴道分娩的150例产妇进行前瞻性研究。根据产妇是否愿意接受硬膜外分娩镇痛,将接受硬膜外镇痛的100例产妇作为硬膜外组,未接受硬膜外镇痛的50例产妇作为对照组。收集产妇入院时(Ta)、镇痛前或宫口开至2~3 cm(T0)及宫口开全时(T3)的外周血,采用酶联免疫吸附试验检测血浆IL-6水平;记录所有产妇各产程时间,T0、镇痛后1 h(T1)、镇痛后2 h(T2)和T3子宫收缩情况以及整个产程催产素使用情况。结果与Ta相比,所有产妇在T0和T3时IL-6水平升高,差异均有统计学意义(P<0.05);与对照组相比,硬膜外组在T3时IL-6水平明显升高,差异均有统计学意义(P<0.05)。与T0相比,所有产妇在T1、T2、T3时子宫收缩明显增强,差异均有统计学意义(P<0.05);硬膜外组在T1、T2、T3时宫缩强度低于对照组,差异均有统计学意义(P<0.05)。与对照组相比,硬膜外组第一产程时长增加,差异有统计学意义(P<0.05)。多因素线性回归结果表明,接受硬膜外镇痛(95%CI:0.011~0.307,P<0.05)、宫口开全时宫缩强度减弱(95%CI:-0.010~-0.006,P<0.001)、第一产程时长增加(95%CI:0.001~0.002,P<0.05)是产妇IL-6水平升高的危险因素(P<0.05)。结论所有经阴道分娩产妇IL-6水平随产程进展逐渐升高,接受硬膜外镇痛、宫缩强度减弱和第一产程时长增加是产妇IL-6水平升高的影响因素。Objective To investigate the changes of plasma IL-6 levels and its influencing factors in parturients with vaginal delivery.Methods An observational study was conducted on 150 primiparas who delivered vaginally in the Department of Obstetrics,the Affiliated Hospital of Jiangsu University from June 2020 to June 2021.According to whether the women were willing to accept epidural labor analgesia,women who received epidural analgesia were assigned to the epidural group(n=100),and women without epidural analgesia as the control group(n=50).The peripheral blood was collected at admission(Ta),before analgesia or cervix open to 2~3 cm(T0)and cervix fully open(T3),and the level of plasma IL-6 was detected by ELISA.The duration of each labor stage,uterine contraction before analgesia or cervix open to 2~3 cm(T0),1 h(T1)and 2 h(T2)after analgesia,and at cervix fully open(T3),as well as the use rate of oxytocin throughout the labor were recorded.Results Compared with the time Ta,the IL-6 levels in the two groups increased at T0 and T3,the differences were statistically significant(P<0.05).Compared with the control group,the IL-6 levels at T3 increased significantly in the epidural group,the differences were statistically significant(P<0.05).Compared with T0,the uterine contraction intensity in the two groups was significantly increased at T1,T2 and T3,the differences were statistically significant(P<0.05);The uterine contraction intensity in epidural group was lower than that in control group at T1,T2 and T3,the differences were statistically significant(P<0.05).Compared with the control group,the duration of the first stage of labor in the epidural group was longer,the difference was statistically significant(P<0.05).Multivariate linear regression indicated that epidural analgesia(95%CI:0.011 to 0.307,P<0.05),the weakening of uterine contraction intensity at cervix fully open(95%CI:-0.010 to-0.006,P<0.001),the increase of the first stage duration(95%CI:0.001 to 0.002,P<0.05)were the risk factors of the increased maternal IL

关 键 词：硬膜外分娩镇痛 白细胞介素-6 宫缩强度 第一产程 

分 类 号：R714.3[医药卫生—妇产科学]