Saldeen P, Olofsson P, Parhar R S, al-Sedairy S
Department of Obstetrics and Gynecology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
Early Hum Dev. 1998 Jan 9;50(2):175-83. doi: 10.1016/s0378-3732(97)00036-2.
The purpose of this study was to investigate prostanoid synthesis in different segments of the umbilicoplacental vascular tree and its relationship to impaired maternal glucose tolerance. Segments from the umbilical artery and vein, allantochorionic artery branches, and the cotyledon artery from 21 women with diabetes or impaired glucose tolerance and 10 healthy women were studied. Production of prostacyclin (PGI2) and thromboxane (TxA2) metabolites was determined. The Mann-Whitney U test, Wilcoxon signed-ranks matched-pairs test, Kruskal-Wallis test, analysis of variance, and simple linear regression analysis were used. A two-tailed P value of < 0.05 was considered statistically significant. From the umbilical artery distal to the cotyledon artery, the PGI2 synthesis decreased and the TxA2 synthesis increased gradually towards the periphery in normal pregnancy. The PGI2/TxA2 ratio was more than 200 times higher in the umbilical artery than in the cotyledon artery. The TxA2 production tended in general to be higher in the diabetic group than in the control group, resulting in significantly lower PGI2/TxA2 ratios in some vessels. The prostanoid production was not significantly correlated to maternal HbA1c or cord C-peptide concentrations. The balance between vascular prostacyclin and thromboxane synthesis in the umbilicoplacental arterial tree changed gradually towards the periphery: the more peripheral, the lower the prostacyclin and the higher the thromboxane production. The physiological role of this phenomenon is unknown, but may be of importance for the equilibration of vascular tone between arteries of different calibers. The altered prostanoid balance found in diabetic pregnancy was not directly attributable to the degree of maternal glycemic control, but may reflect increased free radical activity and peroxide production in diabetes.
本研究的目的是调查脐胎盘血管树不同节段中前列腺素的合成及其与母体糖耐量受损的关系。研究了21例患有糖尿病或糖耐量受损的女性以及10例健康女性的脐动脉和静脉、尿囊绒毛膜动脉分支以及子叶动脉节段。测定了前列环素（PGI2）和血栓素（TxA2）代谢产物的产生。使用了曼-惠特尼U检验、威尔科克森符号秩配对检验、克鲁斯卡尔-沃利斯检验、方差分析和简单线性回归分析。双侧P值<0.05被认为具有统计学意义。在正常妊娠中，从脐动脉远端到子叶动脉，PGI2合成减少，TxA2合成向周边逐渐增加。脐动脉中的PGI2/TxA2比值比子叶动脉中的高200多倍。糖尿病组的TxA2产生总体上倾向于高于对照组，导致某些血管中的PGI2/TxA2比值显著降低。前列腺素的产生与母体糖化血红蛋白或脐带C肽浓度无显著相关性。脐胎盘动脉树中血管前列环素和血栓素合成之间的平衡向周边逐渐变化：越周边，前列环素越低，血栓素产生越高。这种现象的生理作用尚不清楚，但可能对不同管径动脉之间血管张力的平衡很重要。糖尿病妊娠中发现的前列腺素平衡改变并非直接归因于母体血糖控制程度，而是可能反映了糖尿病中自由基活性和过氧化物产生的增加。
