PROSTAGLANDIN EXCRETION IN PREECLAMPSIA

目前认为前列腺素代谢紊乱是先兆子痫发病机制中的主要机制之一。 然而，以前大多数关于这一理论的研究只包括那些已经出现临床明显疾病的女性。 为了研究前列腺素异常是否早于先兆子痫的发生，我们设计了一项巢式病例对照研究，使用从参加NICHD钙预防先兆子痫试验（CPEP）的妇女中前瞻性收集的早在妊娠13周的储存尿液标本。 在这项研究中，我们比较了先兆子痫诊断前的先兆子痫妇女的前列环素和血栓素的尿排泄量，在相当的胎龄正常孕妇。 数据分析表明，在继续发展为先兆子痫的妇女中，前列环素的产生减少发生在先兆子痫的任何临床体征之前的几个月。 收缩血管与舒张血管的类二十烷酸的比例在以后发展为先兆子痫的妇女中显著更高。

A disturbance of prostaglandin metabolism is currently believed to be one of the major mechanisms in the pathogenesis of preeclampsia. Most previous studies of this theory, however, have included only women who had already developed clinically overt disease. In order to investigate whether prostaglandin abnormalities precede the onset of preeclampsia, we have designed a nested case-control study using stored urine specimens prospectively collected as early as thirteen weeks gestation from women participating in the NICHD Trial of Calcium to Prevent Preeclampsia (CPEP). In this study, we compared the urinary excretion of prostacyclin and thromboxane in preeclampsic women before the diagnosis of preeclampsia to that in normal pregnant women at comparable gestational ages. Data analysis demonstrated that in women who go on to develop preeclampsia, reduced prostacyclin production occurs months before any clinical sign of preeclampsia. The ratio of vasoconstricting to vasodilating eicosanoids is significantly higher in women who will later develop preeclampsia.