임신성 고혈압환자와 혈중 Thromboxane 농도
Thromboxane in Pregnancy-Induced Hypertension
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목적 : 임신성 고혈압 환자에서 혈중 thromboxane A2 농도를 측정하여 TxA2가 임신성 고혈압의 병태 생리와 연관성이 있음을 확인하고자 하였다. 연구 방법 : 경증의 전자간증 산모 12명, 중증 전자간증 산모 4명, 정상 대조군 산모 14명을 대상으로 TxA2의 안정 대사물질인 TxB2의 혈중 농도를 효소 면역분석법을 통해 비교 분석하였다. 결과 : 정상 산모군과 경증 전자간증 산모군 사이의 혈중 TxB2의 농도는 유의한 차이가 없었으나 (150±15 pg/mL vs 101±12 pg/mL), 앞의 두 군과 비교시 중증 전자간증 산모에서의 혈중 농도는 유의하게 높게 나타났다 (454±102 pg/mL, p<0.0001). 결론 : 모체 내 혈중 TxA2의 농도는 임신성 고혈압의 병태 생리와 연관되어 질환의 중증도와 관련이 있을 것으로 생각되며, 따라서 이러한 결과는 체내 Tx 합성 과정을 차단하는 aspirin이 임신시 발생하는 고혈압성 질환의 예방과 치료에 효과가 있음을 시사하는 것이라 생각할 수 있다.
Abstract
Objective : High thromboxane level evidence supports pivotal involvement of TxA2 in pathophysiology of pregnancy induced hypertension and provides a strong rationale for pursuing TxA2-blocking strategies in drug development. Methods : The stable metabolites of TXA2 (Thromboxane B2) in maternal blood of 12 patients with mild preeclampsia, 4 patients with severe preeclampsia and 14 normal parturients were measured by competitive enzyme immunoassay. Results : TxB2 concentrations were not increased in mild preeclampsia (101±12 pg/mL, n=12) as compared with normal pregnancy (150±15 pg/mL, n=14), but they were significantly increased in severe preeclampsia (454±102 pg/mL, p<0.0001, n=4). Conclusion : Maternal plasma thromboxane is increased only in severe preeclampsia. Thus, increased thromboxane A2 biosynthesis correlates with disease severity and may have a pathogenetic role in pregnancy-induced hypertension. These findings provide a rationale for the use of aspirin in the treatment as well as in the prevention of this disorder.
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