Ryhänen P, Jouppila R, Lanning M, Jouppila P, Hollmén A, Kouvalainen K
Gynecol Obstet Invest. 1984;17(4):202-7. doi: 10.1159/000299149.
Changes in the peripheral blood leucocyte count, lymphocyte subpopulations, and in 'in vitro' responses of lymphocytes to phytohaemagglutinin and tuberculin after induced labour were investigated in 10 normal parturients and their newborns. Every other parturient was given segmental epidural analgesia at level T 10-12 for pain relief during the first stage of labour. The remaining mothers served as controls. The results of blood samples taken from the mothers before induction of labour and from the newborns immediately after delivery served as basal values against which the results of samples drawn on the 1st and on the 5th day following delivery were compared. A significant (p less than 0.05) increase from the basal values in the total leucocyte count after delivery was found only in those mothers not given epidural analgesia and in their newborns. Similarly, a significant (p less than 0.01) decrease in the T cell count characterized by both E rosette formation and acid alpha-naphthyl acetate esterase staining was found in the peripheral blood only in the mothers (but not the newborns) without epidural analgesia. The differences between the research groups were not, however, significant. The lymphocyte response to phytohaemagglutinin on the 1st and on the 5th day after delivery was also significantly (p less than 0.05) lower in the newborns of the mothers not given epidural analgesia than in those of the mothers given it. The present results show that the depression induced by the stress of parturition in some parameters of cell-mediated immunity of mothers and newborns can be at least partly prevented by using segmental epidural analgesia.
对10名正常产妇及其新生儿在引产术后外周血白细胞计数、淋巴细胞亚群以及淋巴细胞对植物血凝素和结核菌素的“体外”反应变化进行了研究。每隔一名产妇在分娩第一产程给予T 10 - 12节段硬膜外镇痛以缓解疼痛。其余产妇作为对照。将引产术前采集的母亲血样及分娩后立即采集的新生儿血样结果作为基础值,与产后第1天和第5天采集的血样结果进行比较。仅在未接受硬膜外镇痛的母亲及其新生儿中发现产后总白细胞计数较基础值有显著(p < 0.05)升高。同样,仅在未接受硬膜外镇痛的母亲(而非新生儿)外周血中发现以E玫瑰花结形成和酸性α - 萘乙酸酯酶染色为特征的T细胞计数显著(p < 0.01)降低。然而,研究组之间的差异并不显著。未接受硬膜外镇痛母亲的新生儿在产后第1天和第5天对植物血凝素的淋巴细胞反应也显著(p < 0.05)低于接受硬膜外镇痛母亲的新生儿。目前的结果表明,使用节段硬膜外镇痛可至少部分预防分娩应激对母亲和新生儿细胞介导免疫某些参数的抑制作用。