Kim Euy Hyuk, Lim Jay Hak, Kim Young Han, Park Yong Won
Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea.
Yonsei Med J. 2008 Feb 29;49(1):138-43. doi: 10.3349/ymj.2008.49.1.138.
Plasma levels of renin, angiotensin II and aldosterone are increased during normal pregnancy. However, these values in preeclampsia are decreased to nearly that of a nonpregnant subject, and vascular sensitivity to angiotensin II is increased. In preeclampsia, aldosterone is decreased less than rennin. Therefore current studies were undertaken to determine the relationship between aldosterone to renin ratio (ARR) and uterine artery perfusion via RI value.
In this study, the relationship between plasma aldosterone and renin concentration was determined in 27 preeclamptic women and 50 normal pregnant women, whose gestational weeks were matched. The aldosterone to renin ratio was calculated and compared between the two groups. Doppler velocimetry of the uterine artery, which was used to calculate resistance index (RI), was performed on all subjects. The relationship between ARR and RI value was reviewed.
In the preeclampsia group, RI value of the uterine artery was significantly higher than that of normal pregnant women. Both plasma renin and aldosterone concentrations were lower in the preeclampsia group. However, the ratio of these two parameters was significantly higher (38.3 vs. 16.1, p < 0.001); the greater ARR, the higher the RI of the uterine artery (r2 = 0.053, p = 0.048).
This study demonstrates that a high aldosterone to renin ratio may have a negative effect on perfusion of the uterine artery and play an important role in the pathophysiology of preeclampsia.
正常妊娠期间血浆肾素、血管紧张素II和醛固酮水平会升高。然而,子痫前期患者的这些值会降至接近非妊娠状态,且血管对血管紧张素II的敏感性增加。在子痫前期,醛固酮的降低幅度小于肾素。因此,开展了本研究以确定醛固酮与肾素比值(ARR)和通过阻力指数(RI)评估的子宫动脉灌注之间的关系。
本研究测定了27例子痫前期孕妇和50例孕周匹配的正常孕妇的血浆醛固酮和肾素浓度之间的关系。计算并比较了两组的醛固酮与肾素比值。对所有受试者进行子宫动脉多普勒测速以计算阻力指数(RI)。回顾了ARR与RI值之间的关系。
子痫前期组子宫动脉的RI值显著高于正常孕妇组。子痫前期组血浆肾素和醛固酮浓度均较低。然而,这两个参数的比值显著更高(38.3对16.1,p<0.001);ARR越高,子宫动脉的RI越高(r2 = 0.053,p = 0.048)。
本研究表明,高醛固酮与肾素比值可能对子宫动脉灌注产生负面影响,并在子痫前期的病理生理过程中起重要作用。