RENIN-ALDOSTERONE RELATIONSHIPS IN PREGNANCY-INDUCED HYPERTENSION
RENIN-ALDOSTERONE RELATIONSHIPS IN PREGNANCY-INDUCED HYPERTENSION
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DOI：
10.1093/ajh/5.6.366
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发表时间：
1992-06-01
影响因子：
3.2
通讯作者：
WHITWORTH, JA
中科院分区：
文献类型：
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作者：
BROWN, MA;ZAMMIT, VC;WHITWORTH, JA
对83例正常晚期妊娠妇女(P组)、50例妊娠高血压综合征(PIH)组和80例年龄匹配的未服用口服避孕药(NP)的非妊娠妇女血浆肾素(PRC)和醛固酮(PAC)水平进行了测定。正常孕妇24小时尿钠/肌酐比值略高于其他两组(P<；.001)(NP：10+/-4，P：15+/-8，妊高征组：12+/-7；均值+/-SD)。PAC和PAC在正常妊娠妇女中均较高[正常妊娠195例(158~337)vs未孕130例(101~209)，中位数(四分位数范围)；P<；.001]。与此相伴随的是，正常妊娠妇女的logPRC-logPAC关系的斜率(敏感度)略有降低(P<；0.05)。与正常妊娠妇女相比，妊高征组PRC和PAC降低，但PAC：PRC比率增加两倍[PIH 411(277~598)vs正常妊娠195(158~337)，P<；.001]，而妊高征组logPRC-logPAC关系的斜率(敏感度)升高(P<；.001)。因此，正常妊娠晚期的醛固酮释放比例高于非妊娠妇女。醛固酮的这种优先增加可能是由于肾上腺对血管紧张素II的敏感性改变，或者可能反映了妊娠期间非血管紧张素对醛固酮的刺激增强。与正常孕妇相比，妊高征患者的PRC和PAC降低，但对醛固酮的刺激相对更大，这可能是因为肾上腺对血管紧张素II的敏感性增强。
The relationship between plasma renin (PRC) and aldosterone (PAC) concentrations was determined in 83 normal third trimester pregnant women (P), 50 women with pregnancy-induced hypertension (PIH), and 80 age-matched nonpregnant women not taking oral contraceptives (NP). Normal pregnant women had a slightly higher 24-h urine sodium: creatinine ratio than the other groups (P < .001) (NP: 10 +/- 4 v P: 15 +/- 8 v PIH: 12 +/- 7; mean +/- SD). Both PRC and PAC were higher in normal pregnant women as was the ratio PAC:PRC [normal pregnant 195 (158 to 337) v nonpregnant 130 (101 to 209), median (interquartile range); P < .001]. This was accompanied by a slightly reduced slope (sensitivity) of the logPRC-logPAC relationship in normal pregnant women (P < .05).Women with PIH had reduced PRC and PAC compared with normal pregnant women but a two-fold greater increase in PAC:PRC ratio [PIH 411 (277 to 598) v normal pregnancy 195 (158 to 337), P < .001], with a rise in the slope (sensitivity) of the logPRC-logPAC relationship in women with PIH (P < .001).Thus there is proportionately greater aldosterone release in the third trimester of normal pregnancy than in nonpregnant women. This preferential increase in aldosterone may be due to altered adrenal sensitivity to angiotensin II or may reflect enhanced nonangiotensin stimulation of aldosterone during pregnancy. Women with PIH have reduced PRC and PAC but relatively greater stimulation of aldosterone than normal pregnant women, possibly due to enhanced sensitivity of the adrenal glands to angiotensin II.