HYPOCALCIURIA IN PREECLAMPSIA
HYPOCALCIURIA IN PREECLAMPSIA
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DOI：
10.1056/nejm198703193161204
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发表时间：
1987-03-19
影响因子：
158.5
通讯作者：
LARAGH, JH
中科院分区：
文献类型：
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作者：
TAUFIELD, PA;ALES, KL;LARAGH, JH
我们研究了 40 名妊娠晚期的女性，以确定血清钙水平或尿钙排泄的变化是否可以将先兆子痫患者与正常孕妇或患有其他形式妊娠高血压的女性区分开来。我们的研究对象包括 10 名正常孕妇、5 名患有短暂性高血压的孕妇、6 名患有慢性高血压的孕妇、7 名患有慢性高血压并叠加先兆子痫的孕妇以及 12 名患有先兆子痫的孕妇。各组之间的离子钙、磷酸盐和 1,25-二羟基维生素 D 的血清水平没有差异。相比之下，先兆子痫或高血压合并先兆子痫的患者的平均（.+-.SD）24小时尿钙排泄量（42.+-.29和78.+-.49mg）显着低于正常孕妇（313.+-.140mg/24小时）、短暂性高血压妇女（248.+-.139mg/24小时）。小时），或患有慢性高血压的女性（223 .+-. 41 毫克/24 小时）（P < 0.0001）。患有先兆子痫的女性的低钙尿症与钙排泄分数减少有关。尽管先兆子痫女性的平均肌酐清除率降低，但其值范围与其他组重叠。相反，我们观察到钙排泄很少或没有重叠。我们的结论是，由于肾小管对钙的重吸收增加，先兆子痫与低钙尿症相关。钙排泄的测量可能有助于区分先兆子痫和其他形式的妊娠期高血压。
We studied 40 women in the third trimester of pregnancy to determine whether alterations in serum calcium levels or in urinary calcium excretion would distinguish patients with preeclampsia from normal pregnant women or women with other forms of gestational hypertension. Our population included 10 normal pregnant women, 5 pregnant women with transient hypertension, 6 with chronic hypertension, 7 with chronic hypertension and superimposed preeclampsia, and 12 with preeclampsia. The serum levels of ionized calcium, phosphate, and 1,25-dihydroxyvitamin D were not different among the various groups. In contrast, the mean (.+-. SD) 24-hour urinary calcium excretion in the patients with preeclampsia or hypertension with superimposed preeclampsia was significantly lower (42 .+-. 29 and 78 .+-. 49 mg) than that in normal pregnant women (313 .+-. 140 mg per 24 hours), women with transient hypertension (248 .+-. 139 mg per 24 hours), or women with chronic hypertension (223 .+-. 41 mg per 24 hours) (P < 0.0001). The hypocalciuria in the women with preeclampsia was associated with a decreased fractional excretion of calcium. Although the mean creatinine clearance was reduced in the women with preeclampsia, the range of values overlapped with those in the other groups. In contrast, we observed little or no overlap with respect to calcium excretion. We conclude that preeclampsia is associated with hypocalciuria due to increased tubular reabsorption of calcium. Measurement of calcium excretion may be useful in distinguishing preeclampsia from other forms of gestational hypertension.