Strasser T, Vogel M
Von Haunersches Kinderspital, University of Munich, F.R.G.
Biochim Biophys Acta. 1989 May 15;1003(1):63-6. doi: 10.1016/0005-2760(89)90099-4.
To analyze the role of prostaglandin E2 in maintaining ductal patency in premature newborns, we measured the PGE2 concentration in the lung lavage fluid of nine patients within 24 h before and 4-8 h after surgical ligation of a patent ductus arteriosus and in two patients before and after closure of the ductus following intravenous indomethacin. The concentration of PGE2 ranged from 240 to 3770 pg/ml (mean 1666 +/- 1256 pg/ml) before operative intervention and show a significant decrease to 0-300 pg/ml (mean 93 +/- 106 pg/ml, P less than 0.001, Student's two-tailed t-test) within a few hours after ligation of the ductus arteriosus. The same significant decrease could be seen in two patients with successful indomethacin therapy (0.25 mg/kg in three doses/day) with concomitant ductus closure. In contrast, when indomethacin was given in a reduced dose (0.1 mg/kg in three doses/day), only a slight effect on PGE2 synthesis could be seen without closure of ductus arteriosus. We suggest that the fall of PGE2 levels in lung lavage fluid reflects the local synthesis in the ductus arteriosus itself and is responsible for the decrease induced by surgical ligation or pharmacological inhibition by indomethacin.
为分析前列腺素E2在维持早产儿动脉导管通畅中的作用，我们测定了9例动脉导管未闭患儿在手术结扎动脉导管前24小时内及结扎后4 - 8小时肺灌洗液中PGE2的浓度，以及2例静脉注射吲哚美辛前后动脉导管闭合前后肺灌洗液中PGE2的浓度。手术干预前PGE2浓度范围为240至3770 pg/ml（平均1666±1256 pg/ml），在结扎动脉导管后的数小时内显著下降至0 - 300 pg/ml（平均93±106 pg/ml，P<0.001，学生双尾t检验）。在2例吲哚美辛治疗成功（每日3次，每次0.25 mg/kg）且动脉导管闭合的患儿中也观察到了同样显著的下降。相比之下，当给予较低剂量的吲哚美辛（每日3次，每次0.1 mg/kg）时，对PGE2合成仅有轻微影响，动脉导管未闭合。我们认为肺灌洗液中PGE2水平的下降反映了动脉导管本身的局部合成，并且是手术结扎或吲哚美辛药物抑制所导致下降的原因。
