Dürr J A
Am J Kidney Dis. 1987 Apr;9(4):276-83. doi: 10.1016/s0272-6386(87)80122-1.
Diabetes insipidus (DI) and pregnancy may coexist and, when they do, present challenging diagnostic and therapeutic problems. Women with preexisting central DI usually experience increased thirst and require additional hormone replacement. Women with nephrogenic DI have an increased water turnover. Of interest is a group of women with transient DI of gestation. In some of these patients, central DI is brought to the fore by increases in water turnover during pregnancy as well as increments in the metabolic clearance of arginine vasopressin (AVP), especially near term. Others have a "vasopressin-resistant" form of the disease, which in one case followed by us appeared to be due to marked increments in circulating cystine-aminopeptidase (vasopressinase). This patient's DI was resistant to pitressin, but she concentrated her urine when given dDAVP. Her vasopressinase levels 2 weeks postpartum were still several-fold those of normal term gravidas. Her DI remitted, and she concentrated her urine appropriately 2 months postpartum. This article reviews the different forms of DI peculiar to pregnancy.
尿崩症（DI）与妊娠可能并存，一旦并存，就会带来具有挑战性的诊断和治疗问题。患有既往中枢性尿崩症的女性通常会出现口渴加剧的情况，需要额外补充激素。患有肾性尿崩症的女性水转换增加。值得关注的是一组患有妊娠期短暂性尿崩症的女性。在其中一些患者中，中枢性尿崩症因孕期水转换增加以及精氨酸加压素（AVP）代谢清除增加而凸显出来，尤其是在接近足月时。其他患者患有“加压素抵抗”形式的疾病，在我们跟踪的一个病例中，这似乎是由于循环中的胱氨酸氨基肽酶（加压素酶）显著增加所致。该患者的尿崩症对垂体后叶素耐药，但给予去氨加压素时她能浓缩尿液。她产后2周时的加压素酶水平仍比足月孕妇高出数倍。她的尿崩症缓解，产后2个月时她能正常浓缩尿液。本文综述了妊娠特有的不同形式的尿崩症。
