| 杨芬,魏磊,吴一帆,等.白细胞介素 -17和叉头状螺旋转录因子 3在子痫前期发病机制中的作用及剖宫产术后自控镇痛对其表达的影响[J].安徽医药,2021,25(9):1770-1774. |
| 白细胞介素 -17和叉头状螺旋转录因子 3在子痫前期发病机制中的作用及剖宫产术后自控镇痛对其表达的影响 |
| The role of IL-17 and Foxp3 in the pathogenesis of preeclampsia and the effect of patient-controlled analgesia after cesarean section on their expression |
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| DOI：10.3969/j.issn.1009-6469.2021.09.017 |
| 中文关键词: 先兆子痫 腹横肌平面阻滞 硬膜外镇痛 剖宫产术 白细胞介素 -17 叉头状螺旋转录因子 3 |
| 英文关键词: Pre-eclampsia TAP block Epidural analgesia Cesarean section IL-17 Foxp3 |
| 基金项目:苏州市科教兴卫 --青年科技项目( KJXW2017026，KJXW2014019) |
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| 中文摘要: |
| 目的探究白细胞介素 -17(IL-17)和叉头状螺旋转录因子 3(Foxp3)在子痫前期发病机制中的作用，对比重度子痫前期产妇剖宫产术后，超声引导下双侧腹横肌平面( TAP)阻滞复合静脉泵自控镇痛( PCIA)与硬膜外镇痛对疼痛控制及外周血中 IL-17和 Foxp3表达水平的影响。方法筛选 2016年 2月至 2020年 2月苏州市立医院重度子痫前期产妇 40例，按随机数字表法分为两组( n=20)于腰 -硬联合阻滞麻醉( CSEA)下行剖宫产手术，术毕 T组:超声引导下低位 TAP阻滞，双侧各注入 0.375%罗哌卡因 20 mL，复合，舒芬太尼 50 μg+氟比洛芬 200 mg生理盐水稀释至 100 mL静脉自控镇痛； E组: 0.15%罗哌卡因 100 mL+ |
| 英文摘要: |
| Objective To explore the role of IL-17 and Foxp3 in the pathogenesis of preeclampsia, and to compare the effects of ultrasound-guided bilateral TAP block combined with PCIA and epidural analgesia on pain control and IL-17 and Foxp3 expression levels in peripheral blood of severe preeclampsia patients after cesarean section.Methods Forty patients with severe preeclampsiain Suzhou Municipal Hospital from February 2016 to February 2020 were selected and randomly divided into two groups according to random number table method (n=20). Patients were treated with combined spinal-epidural anesthesia and postoperative analgesia. T group:patients underwent ultrasound guided TAP block, bilateral injection of 0.375% ropivacaine 20 mL, combined with sufentanil 50 μg+flurbiprofen 200 mg and normal saline to 100 mL PCIA; E group: patients underwent controlled epidural analgesia with 0.15% ropivacaine 100 mL+0.04 mg/L sufentanil. Another 20 normal pregnant women were selected as control group. Visual analogue scale (VAS)scores were recorded at 6, 12, 24, 48 h post-operation. By the ELISA method, IL-17 and Foxp3 expression levels were detected in maternal peripheral blood in group T and group E when anesthesia began immediately and at 6,12, 24, 48 h post-operation, and in group C when the parturient was admitted to hospital and delivered.Results There was no significant difference in VAS score between group T and group E (P>0.05). In group T and group E, when anesthesia began immediately, the level of IL-17 was significantly higher and the level of Foxp3 was significantly lower than that in group C. In group T and group E, the level of IL-17 was significantly higher and the level of Foxp3 was significantly lower at 6 h post-operation than those when anesthesia began immediately. The level of IL-17 decreased gradually and the level of Foxp3 increased gradually at 24, 48 h post-operation compared with 6 h post-operation. The level of IL-17 was significantly lower and the level of Foxp3 was significantly higher at 24 h post-operation than those at 12 h post-operation; The level of IL-17 was significantly lower and the level of Foxp3 was significantly higher at 48 h postoperation than those when anesthesia began immediately, at 12 h and 24 h post-operation (P<0.05). There was no significant difference in the level of IL-17 and Foxp3 between group T and group E at 6 h and 12 h post-operation (P>0.05). At 24 h and 48 h post-operation, the level of IL-17 in group E was significantly lower than that in group T [(68.98±14.82)ng/L vs. (83.51±15.77)ng/L, (36.38±12.34)ng/L vs. (51.65±18.43)ng/L], the level of Foxp3 in group E was significantly higher than that in group T [(89.36±25.83)ng/L vs. (74.97±23.31)ng/L, (116.17±32.46)ng/L vs. (98.74±27.59)ng/L] (P<0.05).Conclusions The low expression of Foxp3 and the high expression of IL-17 may be involved in the pathogenesis of preeclampsia. Ultrasound-guided bilateral low-level TAP block combined with intravenous analgesia has definite effecton incision pain after cesarean section, effectively regulates the expression of IL-17 and Foxp3, and promotes the prognosis of women with severe preeclampsia, but its anti-inflammatory effect is weaker than that of epidural analgesia. |
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