Prostacyclin and thromboxane levels in women with severe preeclampsia undergoing magnesium sulfate therapy during antepartum and postpartum periods.
Prostacyclin and thromboxane levels in women with severe preeclampsia undergoing magnesium sulfate therapy during antepartum and postpartum periods.
复制标题
产前和产后接受硫酸镁治疗的重度子痫前期女性的前列环素和血栓素水平。
DOI：
10.1080/10641950701825721
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发表时间：
2008
影响因子：
1.5
通讯作者：
Lewis,DavidF
中科院分区：
文献类型：
--
作者：
Wang,Yuping;Zhang,Yanping;Canzoneri,BernardJ;Gu,Yang;Philibert,Lisa;Lewis,DavidF
目的：探讨硫酸镁对重度子痫前期患者产前及产后血浆前列环素(PGI2)和血栓素A2(TXA2)水平的影响。A组产后持续输注硫酸镁24小时。B组，当尿量达到≥100ml/h时，停止给予硫酸镁，连续2小时。收集了患者的人口统计学数据。分别于给药时和产后24小时抽取静脉血。用双抗体夹心酶联免疫吸附测定法测定血浆中PGI2和TXA2的稳定代谢产物6酮前列腺素F1α和TXB2水平。结果：共纳入50例患者，A组27例，B组23例。两组的人口学资料在母亲年龄、孕周、入院时、产后12小时、产后24小时的收缩压和舒张压、分娩方式等方面均无统计学差异。在登记时，血小板计数均在正常范围内。B组产后平均应用硫酸镁10小时，两组产妇产后24小时血压均恢复正常或接近正常水平。6-酮前列腺素F1α水平在产后24小时显著低于入院时(A组：98±13对180±28 pg/m L；B组：142±17对194±31 pg/m L，p<；0.05)。然而，两组之间没有检测到差异。A组和B组入选时TXB2水平分别为38±9和33±8 pg/m L，产后24 h分别为26±5和25±3 pg/m L，差异无统计学意义。结论：应用硫酸镁对先兆子痫患者产前和产后母血中前列环素和血栓素水平无影响。我们推测，分娩前较高水平的前列环素可能反映了这种血管扩张剂的代偿作用，以抵消怀孕期间母亲血压升高的影响。
Objective: To study effects of magnesium sulfate (MgSO4) on prostacyclin (PGI2) and thromboxane A2(TXA2) levels in women with severe preeclampsia during antepartum and postpartum periods.Methods: Women with severe preeclampsia were randomized into two groups. Patients in Group A were continuously infused with MgSO4for 24 hours postpartum. In Group B, MgSO4administration was discontinued when urinary output was of ≥100 ml/hr for 2 consecutive hours. Patient demographic data were collected. Venous blood was drawn at time of MgSO4administration and 24 hours after delivery. Plasma levels of 6-keto-PGF1α and TXB2, stable metabolites of PGI2and TXA2, were measured by enzyme-linked immunosorbent assay (ELISA). Data are presented as mean ± SE, and analyzed by pairedt-test.Results: A total of 50 patients were recruited, with 27 in Group A and 23 in Group B. There were no statistical differences for demographic data between the two groups with regards to maternal age; gestational age; systolic and diastolic blood pressures at admission, 12 hours postpartum, and 24 hours postpartum; and mode of delivery. Platelet counts were all within the normal range at the time of enrollment. MgSO4was administered for an average of 10 hours postpartum in Group B. Maternal blood pressures returned to normal or close to normal levels in both groups at 24 hours postpartum. 6-keto PGF1α levels were significantly decreased 24 hours after delivery compared with the levels at enrollment in both groups, (Group A: 98 ± 13 vs. 180 ± 28 pg/mL; Group B: 142 + 17 vs. 194 ± 31 pg/mL,p< 0.05, respectively). However, there was no difference detected between the two groups. TXB2levels were not different between group A and Group B at the time of enrollment, 38 ± 9 vs. 33 ± 8 pg/mL, and 24 hours postpartum, 26 ± 5 vs. 25 ± 3 pg/mL, respectively.Conclusions: Administration of MgSO4does not affect prostacyclin and thromboxane levels in the maternal circulation in women with preeclampsia during antepartum and postpartum periods. We speculate that a higher level of prostacyclin before delivery may reflect compensatory effects of this vasodilator to offset increased maternal blood pressure during pregnancy.