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[妊娠诱发的动脉高血压中的肾素-血管紧张素-醛固酮系统、血容量、血清尿酸以及前列腺素和激肽释放酶的尿排泄]

[Renin-angiotensin-aldosterone system, blood volume, serum uric acid and urinary excretion of prostaglandins and kallikrein in the arterial hypertension induced by pregnancy].

作者信息

Fiévet P, Agnès E, Hervé M A, de Frémont J F, Carayon A, Andréjak M, Pleskof L, Desailly I, Mimram A, Fournier A

出版信息

Arch Mal Coeur Vaiss. 1984 Oct;77(11):1210-5.

PMID:6441541
Abstract

The plasma renin activity (PRA), plasma volume (PV), urinary excretion of Kallikrein (UK) and PGE2, PGF2 alpha, 6-keto PGF1 alpha and TXB2 were measured in 24 ambulant patients without treatment on normal sodium diets with pregnancy-induced hypertension (HT) (diastolic BP greater than or equal to 90 mmHg, appearing after 20 weeks' pregnancy and absent 2 months after delivery). The UK was measured by an esterase technique, prostaglandins by radioimmunological assay and PV by dye dilution (Evans blue). Two subgroups of patients were identified according to the evolution of their blood pressure at rest at home; the first (7 patients) with labile HT, and the second (14 patients) with permanent HT. The PRA was significantly lower (p less than 0,001) in patients with permanent compared to labile hypertension (4,7 +/- 0,3 compared to 12,2 +/- 0,8 ng/ml/h) and compared to a control group of normotensive pregnant women (6,5 +/- 0,5). The PV, expressed as a percentage of the theoretical volume with respect to the stage of pregnancy and body surface area was low in both groups. In permanent HT: 1) there was no correlation between PV and PRA, 2) a positive correlation between UK and urinary 6-keto PGF1 alpha (r = 0,62; p less than 0,001) and PGE2 (r = -0,51, p less than 0,05). Discriminative linear analysis showed that urinary 6-keto PGF1 alpha was mainly related to PRA and to a lesser degree to UK.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对24例未接受治疗、正常钠饮食的妊娠高血压(HT)(舒张压大于或等于90mmHg,孕20周后出现,产后2个月消失)门诊患者测定血浆肾素活性(PRA)、血容量(PV)、尿激肽释放酶排泄量(UK)以及PGE2、PGF2α、6 - 酮 - PGF1α和TXB2。UK采用酯酶技术测定,前列腺素采用放射免疫分析法测定,PV采用染料稀释法(伊文思蓝)测定。根据患者在家静息血压的变化情况分为两个亚组;第一组(7例)为血压不稳定的HT患者,第二组(14例)为持续性HT患者。与血压不稳定的高血压患者(4.7±0.3 vs 12.2±0.8 ng/ml/h)以及正常血压孕妇对照组(6.5±0.5)相比,持续性HT患者的PRA显著降低(p<0.001)。两组患者以妊娠阶段和体表面积计算的PV占理论值的百分比均较低。在持续性HT患者中:1)PV与PRA之间无相关性,2)UK与尿6 - 酮 - PGF1α(r = 0.62;p<0.001)和PGE2(r = -0.51,p<0.05)呈正相关。判别线性分析显示,尿6 - 酮 - PGF1α主要与PRA相关,与UK的相关性较小。(摘要截短至250字)

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