Weir R J, Doig A, Fraser R, Morton J J, Parboosingh J, Robertson J I, Wilson A
Perspect Nephrol Hypertens. 1976;5:251-61.
Compared with a group of normal pregnant women, matched for age, parity, posture, and length of gestation, women with hypertension and proteinuria in the last trimester had significantly lower plasma concentrations of renin, renin substrate and angiotensin II. Plasma aldosterone and DOC concentrations were also lower in the hypertensive group. The plasma levels of cortisol, corticosterone, and ADH showed no significant difference. Plasma renin concentration was raised throughout normal pregnancy, and part of this increase appeared to be due to the presence of an inactive form of renin. Plasma concentrations of renin substrate, angiotensin II, and aldosterone were also raised in normal pregnant women, but concurrent measurement of these substances showed no significant relationship between them, renin, and plasma electrolytes in mid- or late gestation. A study of five women in the weeks immediately after conception showed increases in plasma angiotensin II and aldosterone concentrations, which were significantly related at this very early stage of pregnancy. Total 24-hour urinary sodium increased gradually from about two weeks after gestation to the end of the study five weeks later. This increase was due mainly to a rise in overnight sodium excretion, with a fall in the day/night ratio. No relationship was found between plasma angiotension II or aldosterone concentrations and day, night, or total 24 hour sodium excretion.
与一组年龄、胎次、姿势和妊娠时长相匹配的正常孕妇相比，孕晚期患有高血压和蛋白尿的女性血浆肾素、肾素底物和血管紧张素II的浓度显著降低。高血压组的血浆醛固酮和脱氧皮质酮浓度也较低。皮质醇、皮质酮和抗利尿激素的血浆水平无显著差异。在整个正常孕期，血浆肾素浓度都会升高，这种升高部分似乎是由于存在一种无活性形式的肾素。正常孕妇血浆肾素底物、血管紧张素II和醛固酮的浓度也会升高，但在妊娠中期或晚期同时测量这些物质时，发现它们之间以及它们与肾素和血浆电解质之间无显著关系。一项对五名女性在受孕后几周内的研究显示，血浆血管紧张素II和醛固酮浓度升高，在妊娠这个非常早期阶段，二者显著相关。妊娠约两周后至五周后的研究结束时，24小时尿钠总量逐渐增加。这种增加主要是由于夜间钠排泄增加，昼夜比值下降。未发现血浆血管紧张素II或醛固酮浓度与白天、夜间或24小时总钠排泄之间存在关联。
