硬膜外分娩镇痛影响子痫前期产妇黏结合蛋白多糖1的前瞻性队列研究

 目的 评估硬膜外分娩镇痛对子痫前期产妇黏结合蛋白多糖1（syndecan-1）的影响。方法 2016年1月至2017年12月，150例大于37孕周的子痫前期初产妇被纳入这项前瞻性队列研究，依据产妇第1次宫颈检查宫口扩张2 cm时是否申请分娩镇痛，分为分娩镇痛组（试验组）和非分娩镇痛组（对照组），每组75例。主要结果是syndecan-1从基础值到干预后2 h的变化平均值和百分数；次要结果是疼痛评分（visual analogue scale，VAS）、IL-6、平均动脉压（mean arterial pressure，MAP）从基础值到干预后2 h的变化。结果 试验组syndecan-1从基础值到干预后2 h的变化平均值为（-11.49±82.80） ng/mL，显著低于对照组的（45.09±55.14） ng/mL （P<0.001），其变化百分数也显著低于对照组（P<0.001）。试验组VAS和MAP较对照组均显著降低（P<0.001）。两组间IL-6水平组差异无统计学意义。结论 硬膜外分娩镇痛可降低syndecan-1水平、VAS和MAP，而对IL-6水平无影响。

A prospective cohort study on the effect of epidural labor analgesia on syndecan-1 in patients with preeclampsia

Objective To evaluate the treatment effects of epidural labor analgesia on syndecan-1 in patients with preeclampsia. Methods During Jan.,2016 and Dec.,2017,150 unipara females with preeclampsia and gestational age>37 weeks were enrolled in the prospective cohort study.They were devided into intervention and control group (n=75 in each group) with and without epidural labor analgesia,based on whether epidural labor analgesia applications were made by the patients at the first examination of cervical dilation of 2 cm.The primary outcomes were mean change and change rate of syndecan-1 from baseline to 2 h post-treatment,and the secondary outcomes were visual analogue scale (VAS),IL-6 level and mean arterial pressure (MAP). Results Absolute change of syndecan-1 from baseline to 2 h post-baseline was (-11.49±82.80) ng/mL in the intervention group and (45.09±55.14) ng/mL in the control group,respectively.There was a significant difference in mean change of syndecan-1 between the two groups (P<0.001).Similarly,the intervention group exhibited a greater reduction in change rate of syndecan-1 compared with the control group (P<0.001).Moreover,theCS] CSD%15,0,10,0] FK(WB8001ZQ2*2] WT10.BZ] intervention group had greater reduction in VAS and MAP compared with the control group (P<0.001 for both).There was no significant difference in IL-6 level between the two groups. Conclusions Epidural labor analgesia was associated with greater reduction in syndecan-1,VAS and MAP compared with the control condition.In contrast,administration of epidural analgesia did not significantly change IL-6 level.