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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 the effect of labor analgesia on serum C3, C4 and C-reactive protein (CRP) in maternal serum. Methods BMI 18 ~ 24kg / m ~ 2, pregnancy 38 ~ 41 weeks of single fetus full-term early 60 women, using random number table divided into analgesic group (30 cases) and control group (30 cases). Analgesia group of pregnant women when the cervix open ≥ 3cm epidural analgesia, the control group did not use any analgesic measures. Immune rate nephelometry was used to determine the level of complement C_3, C_4 and CRP in pregnant women after entering the labor process. Results In the analgesic group, the levels of complement C_3 and C_4 were (1.02 ± 0.01) g / L and (0.22 ± 0.01) g / L, respectively, 0.33 ± 0.03) g / L], the difference was statistically significant (P <0.05). The levels of complement C_3 and C_4 were (1.33 ± 0.02) g / L and (0.30 ± 0.01) g / L at 48 hours postpartum in the analgesic group, respectively, which were significantly different from those of the postpartum 24 h postpartum (P <0.05). The levels of complement C3 and C4 in the control group were (0.86 ± 0.03) g / L and (0.19 ± 0.01) g / L respectively after labor, and were significantly higher than those in the labor group [(1.47 ± 0.05) g / ], The difference was statistically significant (P <0.05). The postnatal 48h complement C3, C4, the difference was statistically significant (P <0.05). (P <0.05). Compared with the control group, the level of CRP in post-partum analgesia group was significantly higher than that in control group (P <0.05) .2 The level of CRP in post-partum analgesia group was significantly higher than that in control group (44.52 ± 11.62 g / L vs 6.78 ± 1.60 g / L [ (21.09 ± 11.81) g / L, compared with the control group (33.22 ± 11.82) g / L, the difference was statistically significant (P <0.05). Conclusion Epidural analgesia can reduce the stress response induced CRP increased, but the complement system did not change significantly.