血清孕酮水平与剖宫产术后疼痛的关系
本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见
Evaluation the relationship between serum progesterone level and pain perception after cesarean delivery
背景与目的
本研究旨在探讨血清孕酮水平与剖宫产术后疼痛程度的关系。
方 法
本研究为一项前瞻性队列研究，共纳入166名孕妇，因这些孕妇既往有剖腹产史而成为择期剖宫产的主要纳入对象。术前测定血清孕酮水平。采用视觉模拟评分法（VAS）评估患者术后4、 8、12和24h的疼痛程度，并评价孕酮水平与疼痛的相关性。
结 果
血清孕酮水平的中位数为119.45 ng/ml。术后4、8、12和24h平均疼痛评分分别为6.80±2.11、5.31±1.48、3.89±1.68和2.30±1.26。按119.45 ng/ml的平均孕酮水平将患者分为两组：高孕酮水平组（119.45ng/ml）和低孕酮水平组（＜119.45ng/ml），在术后不同时间（4、8、12和24h）对两种孕酮水平患者的疼痛程度进行评分。高孕酮组(孕酮水平为119.45ng/ml)4、8、12和24h疼痛评分明显低于低孕酮组(P<0.05)，且术后12h和24h内疼痛评分低于5分的患者人数显著增加。随着BMI的增加，孕酮水平降低，BMI较高的女性在4、8、12和24h具有较高的疼痛评分，而BMI较低的女性在相同时间内具有较低的疼痛评分（P=0.004，r=0.223；P=0.004，r=0.223；P=0.039，r=0.160；P=0.007，r=0.207）。孕酮水平与BMI（p=0.025，r=-0.174）和孕酮水平与术后第4、8、12、24h疼痛评分（p=0.000，r=-0.324；p=0.000，r=-0.474；p=0.000，r=-0.329；p=0.000，r=-0.417）呈显著负相关。在多元回归模型中，孕酮水平与术后4h（p=0.000，r=-0.305）、8h（p=0.000，r=-0.461）、12h（p=0.000，r=-0.328）和24h（p=0.000，r=-0.409）的疼痛评分呈显著负相关。
结 论
血清孕酮水平与剖宫产术后疼痛评分呈负相关。
原始文献摘要
Kashanian M, Dadkhah F, Zarei S, et al. Evaluation the relationship between serum progesterone level and pain perception after cesarean delivery.[J] .J. Matern. Fetal. Neonatal. Med., 2019, 32: 3548-3551.
Objective: The aim of this study was to evaluate the relationship between serum progesterone level and pain perception after cesarean delivery.
Method: The study was performed as a prospective cohort study on 166 pregnant women who were candidates for elective cesarean delivery due to previous cesarean section. Before surgery, serum progesterone level was measured. Pain score of women was evaluated 4, 8, 12, and 24 h after surgery using visual analog scale (VAS) score, and correlation between progesterone level and pain was evaluated.
Results: The median value of serum progesterone was 119.45 ng/ml. Mean pain score in hours 4, 8, 12, and 24 were 6.80 ± 2.11, 5.31 ± 1.48, 3.89 ± 1.68, and 2.30 ± 1.26, respectively. The women were divided according to mean progesterone level of 119.45 ng/ml into two groups of high progesterone level (119.45) and low progesterone level (<119.45), and the pain score was evaluated in different times (hour 4, 8, 12, and 24) for both levels of progesterone. The mean pain score in the 4, 8, 12, and 24 h were significantly lower in high progesterone group (progesterone
level 119.45). The number of women with low pain score (less than five) in hours 12 and 24 was significantly higher in high progesterone level group. With increasing BMI, progesterone level was lower and women with higher BMI, had a higher pain score in hours 4, 8, 12, and 24, while women with lower BMI had a lower pain score during the same hours. (p =.004, r =0.223; p =.004, r =0.223; p = .039, r = 0.160; and p = .007, r = 0.207). Progesterone level and BMI (p = .025, r = -0.174), and progesterone level and pain score in hours 4, 8, 12, and 24 (p =.000, r =-0.324; p = .000, r = -0.474; p = .000, r = -0.329; and p = .000, r = -0.417, respectively) showed a negative significant correlation. Putting three variables of age, gestational age, and BMI in a multiple regression model, progesterone level showed significant negative correlation with the pain score in hour 4 (p = .000, r = -0.305), hour 8 (p =.000, r = -0.461), hour 12 (p =.000, r = -0.328), and hour 24 (p = .000, r = -0.409).
Conclusions: Serum progesterone level showed a negative correlation with the pain score after cesarean section.
麻醉学文献进展分享
贵州医科大学高鸿教授课题组
翻译：何幼芹 编辑：何幼芹 审校：王贵龙