Mizutani S, Kurauchi O, Ito Y, Narita O, Tomoda Y
Department of Obstetrics and Gynecology, Nagoya University School of Medicine, Japan.
Exp Clin Endocrinol. 1988 Dec;92(2):161-70. doi: 10.1055/s-0029-1210796.
We have used estradiol benzoate (E) and Progesterone (P) for the treatment of severe pre-eclampsia and obtained good results in 8 cases. To assess the placental function, we serially measured leucine aminopeptidase (placental type, P-LAP) in serum. As a new trial, we used E and P in place of the hypotensive and diuretic drugs in 8 cases of severe pre-eclampsia. In a typical case, a patient at week 31 of gestation suffered from highly elevated blood pressure (190/130 mmHg) and proteinuria; at this time we started the treatment with E (20 mg/day) and P (80 mg/day), and continued it for 23 days with increasing doses. By this treatment the blood pressure was gradually decreased and the edema improved; the serum P-LAP increased gradually. At week 35, the P-LAP activity decreased suddenly despite the steroid treatment suggesting a placental dysfunction. At this stage we made Cesarean section and a male infant weighing 1.750 g (Apgar score 8) was delivered alive. Until now we have experienced 7 other cases of the successful treatment with the E and P.
我们使用苯甲酸雌二醇(E)和孕酮(P)治疗重度子痫前期,8例取得良好效果。为评估胎盘功能,我们连续测定了血清中的亮氨酸氨基肽酶(胎盘型,P-LAP)。作为一项新试验,我们在8例重度子痫前期患者中使用E和P替代降压药和利尿剂。在一个典型病例中,一名妊娠31周的患者血压极高(190/130 mmHg)且有蛋白尿;此时我们开始用E(20毫克/天)和P(80毫克/天)治疗,并持续23天,剂量逐渐增加。通过这种治疗,血压逐渐下降,水肿改善;血清P-LAP逐渐升高。在第35周时,尽管进行了类固醇治疗,但P-LAP活性突然下降,提示胎盘功能障碍。在此阶段我们进行了剖宫产,娩出一名体重1750克的男婴(阿氏评分8分),存活。到目前为止,我们还经历了另外7例使用E和P成功治疗的病例。