Nishimaki S, Seki K
Department of Pediatrics, Yokohama City University School of Medicine, Kanagawa, Japan.
Prostaglandins Other Lipid Mediat. 1999 Aug;58(1):43-9. doi: 10.1016/s0090-6980(99)00024-6.
A disturbance of prostacyclin (PGI2) and thromboxane A2 (TXA2) balance has been reported in preeclampsia. However, little is known about the concentrations of these prostanoids in neonates born to preeclamptic pregnant women. The purpose of this study is to determine whether the PGI2 and TXA2 concentrations are altered and whether the prostanoid balance correlates to the cerebral blood flow in neonates born to preeclampsia.
Spontaneously voided urine samples were collected from 20 neonates of normotensive and 16 neonates of preeclamptic women during the first 24 h after birth. We measured by radioimmunoassay the concentrations of urinary 6-keto-prostaglandin F1alpha (6-keto-PGF1alpha) and 11-dehydro-thromboxane B2 (11-dehydro-TXB2), respectively. Blood flow velocity in the middle cerebral artery was studied by pulsed Doppler ultrasonography in the neonates between 17 and 38 h after birth.
There was no significant difference between the urinary 6-keto-PGF1alpha in the neonates of mothers with and without preeclampsia (median, 5.3 vs. 3.6 ng/mg of creatinine). In contrast, the urinary 11-dehydro-TXB2 and the ratio of 11-dehydro-TXB2 to 6-keto-PGF1alpha in the neonates of mothers with preeclampsia were significantly lower as compared with the neonates without preeclampsia, respectively (13.7 vs. 20.6 ng/mg of creatinine and 3.0 vs. 5.2, median). The resistance index in the middle cerebral artery was significantly reduced in the neonates with preeclampsia than without preeclampsia (0.67 +/- 0.01 vs. 0.74 +/- 0.02, mean +/- SEM).
There was an association between maternal preeclampsia and the imbalance in the neonatal urinary excretion of PGI2 and TXA2 metabolites. This imbalance may contribute to the regulation of cerebral blood flow.
子痫前期患者中已报道存在前列环素（PGI2）与血栓素A2（TXA2）平衡紊乱。然而，关于子痫前期孕妇所生新生儿体内这些前列腺素的浓度情况却知之甚少。本研究旨在确定PGI2和TXA2浓度是否发生改变，以及前列腺素平衡是否与子痫前期孕妇所生新生儿的脑血流量相关。
在出生后的头24小时内，收集了20名血压正常孕妇所生新生儿以及16名子痫前期孕妇所生新生儿的自然排尿尿液样本。我们分别通过放射免疫分析法测定了尿中6-酮-前列腺素F1α（6-酮-PGF1α）和11-脱氢-血栓素B2（11-脱氢-TXB2）的浓度。在出生后17至38小时的新生儿中，采用脉冲多普勒超声检查研究了大脑中动脉的血流速度。
子痫前期孕妇所生新生儿与非子痫前期孕妇所生新生儿的尿中6-酮-PGF1α浓度无显著差异（中位数分别为5.3 ng/mg肌酐和3.6 ng/mg肌酐）。相比之下，子痫前期孕妇所生新生儿的尿中11-脱氢-TXB2以及11-脱氢-TXB2与6-酮-PGF1α的比值均显著低于非子痫前期孕妇所生新生儿（中位数分别为13.7 ng/mg肌酐对20.6 ng/mg肌酐以及3.0对5.2）。子痫前期新生儿大脑中动脉的阻力指数显著低于非子痫前期新生儿（平均±标准误，分别为0.67±0.01对0.74±0.02）。
母亲子痫前期与新生儿尿中PGI2和TXA2代谢产物排泄失衡之间存在关联。这种失衡可能有助于调节脑血流量。
