【摘要】 目的 :探讨脊神经阻滞是否通过调节孕妇的内分泌水平而发挥其作用。方法 :测定重度妊高征患者 (PIH组 ) 2 0例 ,随机分为蛛网膜下腔阻滞组 (SB)和硬膜外腔阻滞 (EB)组 ,各 10例。正常未孕妇女 (NNP组 ) 12例 ,正常晚期妊娠妇女 (NL P组 ) 18例。3组经腰段脊神经阻滞前、后血浆雌激素水平的变化。雌激素的测定采用放免分析法进行测定。数据用 SPSS软件进行 t检验。结果 :NL P组雌激素水平为 (71.6 6± 19.2 2 ) pg/ ml、PIH组 (2 11.12±47.6 1) pg/ m l较 NNP组 (374.16± 12 2 .6 1) pg/ m l明显降低 (P <0 .0 1) ,PIH组较 NL P组明显降低 (P <0 .0 5 ) ,PIH组 SB(2 37± 6 7.2 3) pg/ m l,EB(2 88.5± 6 1.2 6 ) pg/ ml)后均较阻滞前升高 (P <0 .0 5 ) ,且 EB较 SB升高明显(P <0 .0 5 )。结论 :妊高征病人较正常妊娠晚期妇女体内雌激素水平降低 ,而脊神经阻滞可以提高妊高征病人体内雌激素水平。硬膜外阻滞较蛛网膜下腔阻滞使妊高征病人体内雌激素水平升高更明显。更多还原

【Abstract】 Objective:Our purpose was to explore wheter lumbar spinal nerve block (LSNB) can relieve the symptoms of pregnancy-induced hypertension(PIH) by affecting endocrine level,especially the level of estrogen.Methods:The 20 patients with severe PIH were randomly divided into 2 groups, one with subarachnoid block (SB) (10 patients),the other with epidural block (EB) (10 patients).The controls were 12 noemal non-pregnancy(NNP) women and 18 healthy late pregnancy (NLP) women. We measured the level of plasma estrogen of these women before and after LSNB. The level of estrogen was determined by radio-immune assay Results:The estrogen level of NNP and PIH groups were significantly lower than that of NLP group. The estrogen level of PIH was significantly higher than that of NNP group. In PIH group,the level of estrogen after SB or EB increased,and the level of estrogen after EB was higher than that after SB.Conclusion:Lumbar spinal nerve block can increase the estrogen level of patients with PIH and treat PIH by regulating neuro-endocrine level. Epidural block increases the level of estrogen much more than SB, which suggests that the choice of block method or degree of block is important for the increase of estrogen level in patients with PIH.更多还原