PROSTAGLANDIN EXCRETION IN PREECLAMPSIA

前列腺素代谢紊乱目前被认为是子痫前期发病的主要机制之一。然而，这一理论之前的大多数研究只包括那些已经出现临床显性疾病的女性。为了研究前列腺素异常是否先于子痫前期的发生，我们设计了一项巢式病例对照研究，使用从NICHD钙预防子痫前期试验（CPEP）的妇女中前瞻性收集的早在妊娠13周的尿液标本。在本研究中，我们比较了子痫前期妇女在子痫前期诊断前与同等胎龄正常孕妇尿中前列环素和凝血素的排泄情况。数据分析表明，在发展为子痫前期的妇女中，前列环素的产生在子痫前期的任何临床症状出现前几个月就会减少。血管收缩和血管扩张的二十烷类激素的比例在后来会发展为子痫前期的妇女中明显更高。

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.