Wang Y P, Walsh S W, Guo J D, Zhang J Y
Department of Obstetrics and Gynecology, Medical College of Virginia, Richmond 23298-0034.
Am J Obstet Gynecol. 1991 Dec;165(6 Pt 1):1695-700. doi: 10.1016/0002-9378(91)90017-l.
Preeclampsia is associated with an imbalance between thromboxane and prostacyclin. The cause of the imbalance is unknown. Preeclampsia sera contain cytotoxic factors that can damage endothelial cells. Lipid peroxides can damage cell membranes, so elevated levels in the mother's blood could be related to endothelial cell injury and decreased prostacyclin in preeclampsia. This study determined maternal plasma levels of thromboxane and prostacyclin and serum levels of lipid peroxides and vitamin E in women with normal pregnancy (n = 12), mild preeclampsia (n = 16), and severe preeclampsia (n = 19) between 36 and 40 weeks' gestation. In normal pregnancy the ratio of thromboxane to prostacyclin (0.63) favored prostacyclin, and the ratio of lipid peroxides to vitamin E (0.43) favored vitamin E. Prostacyclin was significantly decreased in both mild and severe preeclampsia. Thromboxane was not increased in mild preeclampsia but was significantly increased in severe preeclampsia. The ratio of thromboxane to prostacyclin was increased in mild preeclampsia (0.77) and greatly increased in severe preeclampsia (1.94). Lipid peroxides were significantly increased in mild preeclampsia and increased further in severe preelcampsia. Vitamin E levels were unaltered in mild preeclampsia but significantly decreased in severe preeclampsia. The ratio of lipid peroxides to vitamin E was increased in mild (0.52) and greatly increased in severe (1.09) preeclampsia. We concluded the following: (1) Maternal plasma prostacyclin is decreased in both mild and severe preeclampsia, but thromboxane is increased only in severe cases. (2) Lipid peroxides are significantly increased in both mild and severe preeclampsia and vitamin E is significantly decreased in severe preeclampsia. We speculate that this imbalance could result in endothelial and platelet cell damage and in decreased prostacyclin and increased thromboxane synthesis. (3) Preeclampsia is associated with an imbalance not only between thromboxane and prostacyclin but also between lipid peroxides and vitamin E in maternal blood. The imbalances progressively favor thromboxane and lipid peroxides with the increasing severity of preeclampsia, which is consistent with the clinical symptoms of this disorder.
子痫前期与血栓素和前列环素之间的失衡有关。这种失衡的原因尚不清楚。子痫前期血清中含有可损伤内皮细胞的细胞毒性因子。脂质过氧化物可损伤细胞膜，因此母体血液中脂质过氧化物水平升高可能与子痫前期的内皮细胞损伤及前列环素减少有关。本研究测定了妊娠36至40周的正常妊娠女性（n = 12）、轻度子痫前期女性（n = 16）和重度子痫前期女性（n = 19）的母体血浆血栓素和前列环素水平以及血清脂质过氧化物和维生素E水平。在正常妊娠中，血栓素与前列环素的比值（0.63）有利于前列环素，脂质过氧化物与维生素E的比值（0.43）有利于维生素E。轻度和重度子痫前期的前列环素均显著降低。轻度子痫前期的血栓素未升高，但重度子痫前期显著升高。轻度子痫前期血栓素与前列环素的比值升高（0.77），重度子痫前期大幅升高（1.94）。轻度子痫前期脂质过氧化物显著升高，重度子痫前期进一步升高。轻度子痫前期维生素E水平未改变，但重度子痫前期显著降低。轻度子痫前期脂质过氧化物与维生素E的比值升高（0.52），重度子痫前期大幅升高（1.09）。我们得出以下结论：（1）轻度和重度子痫前期母体血浆前列环素均降低，但血栓素仅在重度病例中升高。（2）轻度和重度子痫前期脂质过氧化物均显著升高，重度子痫前期维生素E显著降低。我们推测这种失衡可能导致内皮细胞和血小板细胞损伤，以及前列环素合成减少和血栓素合成增加。（3）子痫前期不仅与母体血液中血栓素和前列环素之间的失衡有关，还与脂质过氧化物和维生素E之间的失衡有关。随着子痫前期严重程度的增加，这些失衡逐渐有利于血栓素和脂质过氧化物，这与该疾病的临床症状一致。
