Greenwood John P, Scott Eleanor M, Walker James J, Stoker John B, Mary David A S G
Department of Cardiology, St James's University Hospital, Leeds, United Kingdom.
Am J Hypertens. 2003 Mar;16(3):194-9. doi: 10.1016/s0895-7061(02)03256-9.
It is unclear whether pregnancy-induced hypertension (PIH) and preeclampsia (PE) are separate conditions or represent opposite ends of a spectrum of a single disease entity. Sympathetic hyperactivity exists in both PIH and PE; however, only the latter is characterized by multiorgan involvement, particularly renal impairment. As there is evidence in hypertension that target organ damage is associated with increased sympathetic drive, this study was designed to test the hypothesis that the magnitude of sympathetic hyperactivity in PE is greater than that in PIH.
Microneurography was used to compare peripheral sympathetic neural discharge, its reflex control and end-organ effect (plethysmographic measurement of calf blood flow) in 33 women with PIH, PE, and normal pregnancy (NP) who were matched for age, body weight, and gestation.
As expected, patients with PIH and PE had higher levels of mean arterial pressure than those with NP. The frequency of sympathetic neural discharge was greater in the hypertensive disorders of pregnancy compared with NP; however, it was not increased in PE compared with PIH as might be expected.
Based on the study results, PE is not associated with greater sympathetic hyperactivity than PIH, suggesting that any renal impairment in PE involves mechanisms that are not solely dependent on sympathetic hyperactivity.
妊娠高血压（PIH）和先兆子痫（PE）是两种不同的病症，还是单一疾病实体连续谱的两端，目前尚不清楚。PIH和PE均存在交感神经功能亢进；然而，只有后者具有多器官受累的特征，尤其是肾功能损害。由于在高血压方面有证据表明靶器官损伤与交感神经驱动增加有关，因此本研究旨在验证PE交感神经功能亢进程度大于PIH这一假设。
采用微神经ography技术比较33例年龄、体重和孕周匹配的PIH、PE和正常妊娠（NP）女性的外周交感神经放电、其反射控制和终末器官效应（通过体积描记法测量小腿血流量）。
正如预期的那样，PIH和PE患者的平均动脉压水平高于NP患者。与NP相比，妊娠高血压疾病患者的交感神经放电频率更高；然而，与预期相反，与PIH相比，PE患者的交感神经放电频率并未增加。
基于研究结果，PE与比PIH更大的交感神经功能亢进无关，这表明PE中的任何肾功能损害涉及的机制并非仅依赖于交感神经功能亢进。
