摘要
目的探讨椎管内阻滞对子痫前期孕鼠的围产期炎症反应、内皮细胞糖萼脱落及分娩结局的影响。方法选择SPF级SD雌性大鼠20只,8~12周龄,建立子痫前期孕鼠的动物模型,随机分为生理盐水组(N组, n = 10)和鞘内置管组(I组, n =10)。N组孕鼠皮下注射生理盐水,I组孕鼠经鞘内导管注入0.75%布比卡因 40 μL ,每8 h重复一次,直至仔鼠娩出。使用ELISA法在不同时间点测定两组的糖萼标志物黏结蛋白聚糖-1(syndecan-1)、硫酸乙酰肝素(heparan sulfate,HS)、高迁移率族蛋白(high mobility group box-1,HMGB-1)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)水平,测量收缩压(systolic blood pressure,SBP)和24 h尿蛋白定量,记录分娩结局。结果 I组中1只孕鼠在注射布比卡因后死亡,其余19只孕鼠纳入研究。妊娠第16天和第19天,N组syndecan-1 ( P <0.001, P =0.001)、HS ( P <0.001, P =0.001)、HMGB-1 ( P <0.001, P =0.001)及TNF-α( P =0.025,0.006)水平均显著高于I组。N组顺产率显著低于I组( P =0.018),而N组与I组的剖宫产率和流产率差异均无统计学意义,N组异常仔鼠的发生率显著高于I组( P <0.001),N组仔鼠体质量显著低于I组( P <0.001)。第19天,N组SBP水平显著高于I组( P <0.001)。结论椎管内阻滞可以减弱子痫前期孕鼠的糖萼损伤和炎症反应,降低血压并改善分娩结局。
Objective To evaluate the treatment effects of neuraxial block on inflammation,endothelial glycocalyx and obstetrics consequences in pregnant mice with preeclampsia. Methods Twenty female SD rats aged 8-12 weeks were selected.After the establishment of the animal model of pre-eclampsia pregnant mice,pregnant mice were randomly divided into normal saline group (group N, n =10) and intrathecal tube group (group I, n =10).Normal saline was injected subcutaneously in group N, 0.75 % bupivacaine 40 μL was injected through intrathecal tube every 8 h until the neonatal rats were delivered in group I.The outcomes included levels of syndecan-1,heparan sulfate (HS),high mobility group box-1 (HMGB-1), tumor necrosis factor α(TNF-α), systolic blood pressure (SBP), proteinuria for 24 h and obstetricsconsequences. Results One pregnant rat died after being injected with bupivacaine in group I,so a total of 19 pregnant mice were included in this study.The levels of Syndecan-1 ( P <0.001, P =0.001),HS ( P <0.001, P =0.001),HMGB-1 ( P <0.001, P =0.001) and TNF-α( P =0.025, P =0.006) in group N at 16 d and 19 d were significantly higher than that in group I,respectively.The rate of natural birth in group N was significantly lower than that in group I ( P = 0.018 ).However,there was no statistically significant differences in cesarean section rate and abortion rate between the two groups.The incidence of abnormal neonatal rats in group N was significantly higher than that in group I ( P <0.001),and the weight of neonatal rats in group N was significantly lower than that in group I ( P <0.001).SBP level of group N at 19 d was significantly higher than that of group I ( P < 0.001 ). Conclusions Neuraxial block can reduce endothelial glycocalyx damage and inflammation,lower blood pressure and improve obstetric outcomes in preeclampsia pregnant rats.
作者
孙申
黄绍强
田复波
袁红斌
SUN Shen;HUANG Shao-qiang;TIAN Fu-bo;YUAN Hong-bin(Department of Anesthesiology,Changzheng Hospital,Second Military Medical University,Shanghai 200003,China;Department of Anesthesiology,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200090,China)
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2019年第5期631-636,共6页
Fudan University Journal of Medical Sciences
基金
上海市科委优秀技术带头人项目(17XD1424300)~~
关键词
子痫前期
椎管内阻滞
糖萼
分娩结局
孕鼠
preeclampsia
neuraxial block
endothelial glycoealyx
obstetrics consequences
pregnant mice
