Lopez-Espinoza I, Dhar H, Humphreys S, Redman C W
Br J Obstet Gynaecol. 1986 Feb;93(2):176-81. doi: 10.1111/j.1471-0528.1986.tb07883.x.
Urinary albumin excretion during pregnancy has been studied using a sensitive radioimmunoassay. One hundred pregnant women attending a high-risk antenatal clinic and 14 normal pregnant women were investigated serially, during pregnancy and post-partum. The normal subjects showed a small but significant rise in albumin excretion in the third trimester, which was sustained pre-delivery and in the first postnatal week. Twenty-six women were classified as having mild pre-eclampsia and 44 as having chronic hypertension without evidence of superimposed pre-eclampsia. In neither group was there evidence of proteinuria by conventional testing, nor was the median albumin excretion different from normal antenatally; in the first week after delivery a significant increase was observed, but this regressed to normal 6 weeks later. Eight patients developed severe pre-eclampsia, of whom one had evidence of underlying renal disease. Three presented with proteinuria already established. In the remaining five patients, the shift from normal to high albumin excretion occurred rapidly, usually preceded by a rise in uric acid and a decrease in the platelet count. These data suggest that proteinuric pre-eclampsia, as defined by relatively insensitive routine laboratory measurement, is not preceded by a phase of increasing albumin loss which can be detected by more sensitive assays.
已使用灵敏的放射免疫分析法对孕期尿白蛋白排泄情况进行了研究。对100名在高危产前门诊就诊的孕妇和14名正常孕妇在孕期及产后进行了连续调查。正常受试者在孕晚期白蛋白排泄量有小幅但显著的升高，这种升高在分娩前及产后第一周持续存在。26名女性被归类为轻度子痫前期，44名患有慢性高血压但无叠加子痫前期的证据。两组通过传统检测均未发现蛋白尿证据，产前白蛋白排泄中位数也与正常情况无异；产后第一周观察到显著增加，但6周后恢复正常。8名患者发展为重度子痫前期，其中1名有潜在肾脏疾病证据。3名患者已出现蛋白尿。在其余5名患者中，白蛋白排泄从正常转为高水平发生迅速，通常先有尿酸升高和血小板计数下降。这些数据表明，相对不敏感的常规实验室测量所定义的蛋白尿性子痫前期，在可通过更灵敏检测方法检测到的白蛋白丢失增加阶段之前并未出现。
