艾司氯胺酮剖宫产术后干预对产后抑郁和Treg细胞数量比例、IL-10表达的影响  

Effects of intervention with esmketamine after cesarean section on postpartum depression,Treg cell percentage and IL-10 expression

作　　者：杨芬[1] 魏磊[1] 吴一帆 沈濛溦 昝莉莉 苏惠斌[1] YANG Fen;WEI Lei;WU Yifan;SHEN Mengwei;ZAN Lili;SU Huibin(Department of Anesthesia,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou 215002)

机构地区：[1]南京医科大学附属苏州医院麻醉科,苏州215002

出　　处：《南通大学学报（医学版）》2023年第3期253-257,共5页Journal of Nantong University(Medical sciences)

基　　金：江苏省妇幼保健协会科研课题(FYX202024)。

摘　　要：目的:探究艾司氯胺酮用于剖宫产术后静脉镇痛泵中对产妇产后抑郁及调节性T细胞(regulatory T cell,Treg细胞)数量比例、IL-10表达水平的影响。方法:选择剖宫产产妇80例,随机分为艾司氯胺酮组(E组)和对照组(C组),各40例。两组术后均使用静脉自控镇痛泵,E组泵中加入0.4 mg/kg艾司氯胺酮,C组未加。使用爱丁堡产后抑郁量表(Edinburgh postnatal depression score,EPDS)评估产妇抑郁程度,计算两组产妇产后第3天和第42天抑郁发生率。流式细胞术检测产妇入院时、产后第3天和第42天外周血中Treg细胞数量比例,ELISA检测IL-10的表达水平。采用Pearson直线相关性分析EPDS评分与Treg细胞数量比例、IL-10表达水平的相关性。结果:产后第3天和第42天,E组产后EPDS评分和抑郁症发生率明显低于C组(P<0.05),C组Treg细胞数量比例和IL-10表达水平明显低于入院时(P<0.05);E组Treg细胞数量比例和IL-10表达水平明显高于C组(P<0.05);EPDS评分与Treg细胞数量比例呈负相关(r=-0.505、-0.503,P<0.05),且EPDS评分与IL-10表达水平呈负相关(r=-0.524、-0.511,P<0.05)。结论:艾司氯胺酮可能通过有效调节Treg细胞数量比例,促使分泌IL-10来减轻炎症反应,从而有助于预防或减轻产后抑郁。Objective:To observe the effects of esmketamine using intravenous analgesia pump on postpartum depression and the percentage of regulatory T cell(Treg cell),the level of IL-10 after cesarean section.Methods:Eighty cases of cesarean section were randomly divided into esmketamine group(group E)and control group(group C),40 cases in each groups.Puerpera in the two groups were treated with patient-controlled intravenous analgesia pump after opertion,and the doses of esmketamine in the pump were 0.4 mg/kg in group E and 0 mg/kg in group C.Edinburgh postnatal depression score(EPDS)was used to assess maternal depression,and calculate the incidence of depression on the third day and the forty-second day after delivery in two groups.The percentage of Treg cells in peripheral blood in puerpera on the third day and the forty-second day after delivery was detected by flow cytometry and the expression levels of IL-10 were detected by the ELISA method.The correlation between EPDS score and Treg cell ratio and IL-10 expression level was analyzed by Pearson-linear correlation.Results:On the third day and the forty-second day after delivery,the EPDS scores and incidence of postpartum depression in group E were significantly lower than those in group C(P<0.05);the percentage of Treg cells and the expression level of IL-10 in the peripheral blood in group C were significantly lower than those on admission(P<0.05);the percentage of Treg cells and the expression level of IL-10 in the peripheral blood of group E were significantly higher than those in group C(P<0.05);EPDS score was negatively correlated with the proportion of Treg cells(r=-0.505,-0.503,P<0.05),and EPDS score was negatively correlated with the expression level of IL-10(r=-0.524,-0.511,P<0.05).Conclusion:Esmketamine may inhibit inflammatory response by appropriately regulating the proportion of Treg cell,and promoting the secretion of IL-10,so as to prevent or reduce postpartum depression.

关 键 词：产后抑郁症 剖宫产 艾司氯胺酮 调节性T细胞 白细胞介素10 

分 类 号：R614[医药卫生—麻醉学]