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[正常血压孕妇分娩前后血浆心房利钠因子、哇巴因置换因子尿排泄及多巴胺的序贯研究]

[Sequential study of the plasmatic atrial natriuretic factor and the urinary excretion of an ouabain displacing factor and of dopamine in normotensive pregnant women before and after labor].

作者信息

el Esper N, Gregoire I, Fievet P, Lalau J D, Westeel P F, Favre H, de Bold A, Fournier A

机构信息

Service de néphrologie-médecine interne, CHRU, hôpital Sud, Amiens, France.

出版信息

Arch Mal Coeur Vaiss. 1989 Jul;82(7):1057-61.

PMID:2554833
Abstract

Estimation of urinary excretion of a ouabain displacing factor (ODF) and dopamine was carried out immediately before delivery, 7 days and 70-90 days after delivery in 12 normotensive pregnant women. Simultaneous estimation of plasma 99-126 atrial natriuretic factor (ANF), plasma renin activity (PRA) and plasma aldosterone were also undertaken. The data were compared with those obtained in a non pregnant normotensive group of women (n = 14) and a group of pregnant normotensive women in the early third trimester (n = 14). Urinary ODF and dopamine were significantly higher in the early third trimester when compared with non pregnant women but immediately before delivery, ODF excretion had fallen below non pregnant values and dopamine excretion had dropped to control values. Both remained low after delivery. Plasma ANF was higher in pregnant women when compared with non pregnant controls and remained high just before delivery and 7 and 70-90 days after delivery. PRA and plasma aldosterone were higher during pregnancy and had fallen to non pregnant values 7 days post-partum. It is concluded that there is considerable discrepancy in the evolution of natriuretic and antinatriuretic factors before and after delivery and that the drop of PRA and aldosterone by 7 days post-partum, contrasting with the unchanged high values of ANF, may contribute to negative sodium balance after delivery.

摘要

对12名血压正常的孕妇在分娩前、分娩后7天以及分娩后70 - 90天进行了哇巴因置换因子(ODF)和多巴胺尿排泄量的测定。同时还对血浆99 - 126心房利钠因子(ANF)、血浆肾素活性(PRA)和血浆醛固酮进行了测定。将这些数据与在一组非妊娠血压正常的女性(n = 14)和一组妊娠晚期血压正常的女性(n = 14)中获得的数据进行比较。与非妊娠女性相比,妊娠晚期尿ODF和多巴胺显著升高,但在分娩前,ODF排泄量已降至非妊娠水平以下,多巴胺排泄量已降至对照值。分娩后两者均保持在低水平。与非妊娠对照组相比,孕妇血浆ANF较高,且在分娩前、分娩后7天以及分娩后70 - 90天均保持较高水平。妊娠期间PRA和血浆醛固酮较高,产后7天降至非妊娠水平。结论是,分娩前后利钠和抗利钠因子的变化存在相当大的差异,产后7天PRA和醛固酮下降,而ANF值保持不变,这可能导致产后负钠平衡。

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