Hironaka K, Makino H, Kumagai I, Haramoto T, Yamasaki Y, Shikata K, Takahashi M, Nishii M, Ota Z
Third Department of Medicine, Okayama University Medical School, Japan.
Diabet Med. 1992 Apr;9(3):307-11. doi: 10.1111/j.1464-5491.1992.tb01785.x.
A 29-year-old diabetic woman who developed severe anaemia, nephrotic syndrome, and hypertension before the 28th week of gestation, had residual evidence of toxaemia and renal dysfunction more than 1 month following delivery. The histopathological findings of renal biopsy specimens were considered most consistent with toxaemia of pregnancy complicated by diabetic glomerulosclerosis. We consider that rapid acceleration of renal dysfunction may have been induced by: (1) poor control of diabetes before pregnancy; (2) glomerular hyperfiltration of the remnant nephrons throughout pregnancy; (3) hypercoagulopathy associated with pregnancy; (4) appearance of hypertension following these three conditions.
一名29岁的糖尿病女性在妊娠28周前出现严重贫血、肾病综合征和高血压，产后1个多月仍有子痫前期和肾功能不全的残留证据。肾活检标本的组织病理学结果被认为最符合妊娠子痫前期合并糖尿病性肾小球硬化。我们认为，肾功能不全的快速进展可能是由以下因素引起的：（1）妊娠前糖尿病控制不佳；（2）整个妊娠期残余肾单位的肾小球高滤过；（3）与妊娠相关的高凝状态；（4）在上述三种情况出现后出现高血压。
