Vøllestad Nina K, Torjesen Peter A, Robinson Hilde Stendal
Department of Health Sciences, Institute of Health and Society, University of Oslo, Norway.
Man Ther. 2012 Jun;17(3):225-30. doi: 10.1016/j.math.2012.01.003. Epub 2012 Jan 30.
There is a common belief that the laxity of pelvic joints increases in pregnancy. The hormone relaxin is suggested to be one of the most influential factors implementing this effect. Furthermore, increased laxity is assumed to induce pelvic girdle pain (PGP). The objectives were to examine the serum relaxin levels in pregnancy and to investigate whether relaxin levels relate to symptoms and clinical tests for PGP. Data from questionnaires, clinical tests and blood samples were collected once in pregnancy (gestation week 5-24) from 212 women. Serum from blood samples were analyzed by ELIZA to determine the concentration of relaxin. Self reported symptoms were assessed by Disability Rating Index (DRI) and pain intensity (VAS). Clinical examinations included Active Straight Leg Raise (ASLR) test and pain provocation tests. ANOVA was used to assess the effect of gestation age and multivariable statistics to examine the association between relaxin levels and the symptoms or responses to clinical tests. The serum levels of relaxin varied widely between individuals and were only marginally influenced by the gestation age. There was no association between gestation age and responses to clinical tests or pain intensity, but DRI increased with gestation age. Serum concentration of relaxin showed a significant association to positive score on the ASLR test, but no significant associations to responses to pain provocation tests, pain intensity or DRI. The results indicate that relaxin contributes to laxity of pelvic joints in pregnancy. Yet, no evidence of relaxin having an impact on symptoms or perceived disability was found.
有一种普遍的看法认为，孕期骨盆关节的松弛度会增加。激素松弛素被认为是产生这种影响的最具影响力的因素之一。此外，人们认为松弛度增加会导致骨盆带疼痛（PGP）。本研究的目的是检测孕期血清松弛素水平，并调查松弛素水平是否与PGP的症状及临床检查结果相关。研究人员在孕期（妊娠第5 - 24周）收集了212名女性的问卷、临床检查及血样数据。采用酶联免疫吸附测定法（ELISA）分析血样血清，以确定松弛素的浓度。通过残疾评定指数（DRI）和疼痛强度（视觉模拟评分法，VAS）评估自我报告的症状。临床检查包括主动直腿抬高（ASLR）试验和疼痛激发试验。采用方差分析评估孕周的影响，并运用多变量统计方法检验松弛素水平与症状或临床检查反应之间的关联。个体之间的血清松弛素水平差异很大，且仅受孕周的轻微影响。孕周与临床检查反应或疼痛强度之间无关联，但DRI随孕周增加。血清松弛素浓度与ASLR试验阳性评分呈显著相关，但与疼痛激发试验反应、疼痛强度或DRI无显著关联。结果表明，松弛素在孕期会导致骨盆关节松弛。然而，未发现松弛素对症状或感知到的残疾有影响的证据。
