Department of Gynecology and Obstetrics, Botucatu Medical School and Department of Chemistry and Biological Sciences, Institute of Biosciences, Sao Paulo State University, UNESP, Botucatu, SP, Brazil.
Department of Gynecology and Obstetrics, Botucatu Medical School and Department of Chemistry and Biological Sciences, Institute of Biosciences, Sao Paulo State University, UNESP, Botucatu, SP, Brazil; Department of Chemistry and Biological Sciences, Institute of Biosciences, Sao Paulo State University, UNESP, Botucatu, SP, Brazil.
Pregnancy Hypertens. 2022 Aug;29:46-53. doi: 10.1016/j.preghy.2022.06.002. Epub 2022 Jun 17.
This study compared the modulatory effect of two intravenous magnesium sulfate (MgSO) regimens on the systemic inflammatory response in pregnant women diagnosed with imminent eclampsia.
In a single-blind cross-sectional study, 33 women were allocated according to the Zuspan (n = 16) and Sibai (n = 17) MgSO regimens, and treated for 24 h. Blood samples were collected pre-administration of the loading dose, at 24 h of the maintenance dose of MgSO, and at 48 h, when patients were without treatment. Plasma was used to determine interleukin (IL)-1 beta (IL-1β), IL-6, IL-10, tumor necrosis factor-alpha (TNF-α), heat shock protein (Hsp70), and heme oxygenase-1 (HO-1) by ELISA.
The treatment with the Zuspan's regimen didn't change plasma concentrations of TNF-α, IL-10, and Hsp70 in the three-time points studied. However, it decreased IL-1β at 24 h and 48 h and IL-6 at 48 h, and increased HO-1 concentration at 48 h. On the other hand, compared to the pre-treatment period, Sibai's regimen induced a significant decrease in TNF-α, IL-1β, IL-6, and Hsp70, while increased HO-1 levels both at 24 h and 48 h and, IL-10 concentration at 48 h.
Sibai's regimen determined an early and efficient immunoregulatory effect on systemic inflammatory response in preeclampsia, suggesting that the maintenance dose of two grams of MgSO was better than one gram in the treatment of imminent eclampsia.
本研究比较了两种静脉注射硫酸镁（MgSO）方案对即将发生子痫的孕妇全身炎症反应的调节作用。
在一项单盲交叉研究中，根据 Zuspan（n=16）和 Sibai（n=17）MgSO 方案将 33 名妇女进行分配，并接受 24 小时治疗。在给予负荷剂量前、MgSO 维持剂量 24 小时和 48 小时时采集血样，此时患者未接受治疗。通过 ELISA 法测定血浆中白细胞介素（IL）-1β（IL-1β）、IL-6、IL-10、肿瘤坏死因子-α（TNF-α）、热休克蛋白（Hsp70）和血红素加氧酶-1（HO-1）的浓度。
Zuspan 方案的治疗并未改变三个时间点的 TNF-α、IL-10 和 Hsp70 血浆浓度。然而，它降低了 24 小时和 48 小时时的 IL-1β和 IL-6，并增加了 48 小时时的 HO-1 浓度。另一方面，与治疗前相比，Sibai 方案诱导 TNF-α、IL-1β、IL-6 和 Hsp70 显著降低，而在 24 小时和 48 小时时增加了 HO-1 水平，并且在 48 小时时增加了 IL-10 浓度。
Sibai 方案对子痫前期全身炎症反应产生了早期和有效的免疫调节作用，表明在治疗即将发生的子痫时，两克硫酸镁的维持剂量优于一克。
