Fiévet P, Fournier A, De Bold A, el-Esper N, Grégoire I, Renaud H, Westeel P F, Makdassi R
Service de Néphrologie, CHU Amiens, France.
Arch Mal Coeur Vaiss. 1987 Jun;80(6):936-41.
Plasma cardionatrine was measured during pregnancy in 14 normotensive non pregnant women, 15 normotensive pregnant women, 35 pregnancy induced hypertension (PIH) and 10 preeclampsia (PE) and again 2 months after delivery in respectively 7, 15 and 7 cases together with plasma volume, PRA and plasma aldosterone. The plasma levels of cardionatrine are higher in pregnant normotensive women than in non pregnant normotensive women suggesting that pregnancy per se stimulates cardionatrine secretion. The higher levels of cardionatrine in PIH and specially in PE during pregnancy and the greater decrease of plasma cardionatrine after delivery in the hypertensive patients than in the normotensive controls exclude a deficiency of cardionatrine secretion in the pathogenesis of hypertension. These data rather suggest a compensatory role of cardionatrine in the prevention of blood pressure increase. Plasma volume was decreased in PIH (-17 p. 100) and in preeclampsia (-25 p. 100). The simultaneous high levels of cardionatrin may explain the inappropriate stimulation of the renin and aldosterone secretion in these hypovolemic hypertensive states.
在孕期对14名血压正常的未孕女性、15名血压正常的孕妇、35名妊娠高血压综合征(PIH)患者和10名先兆子痫(PE)患者检测了血浆心钠素水平,并在产后2个月分别对7例、15例和7例上述患者再次进行检测,同时检测了血浆容量、肾素活性(PRA)和血浆醛固酮水平。血压正常的孕妇血浆心钠素水平高于血压正常的未孕女性,提示妊娠本身可刺激心钠素分泌。妊娠期间PIH患者尤其是PE患者的心钠素水平较高,且高血压患者产后血浆心钠素水平的下降幅度大于血压正常的对照组,这排除了心钠素分泌不足在高血压发病机制中的作用。这些数据反而提示心钠素在预防血压升高方面具有代偿作用。PIH患者(下降17%)和先兆子痫患者(下降25%)的血浆容量减少。心钠素同时处于高水平可能解释了这些低血容量性高血压状态下肾素和醛固酮分泌的不适当增加。