Marks A D
Postgrad Med. 1983 Jun;73(6):75-83. doi: 10.1080/00325481.1983.11697862.
When a capillary or renal disturbance is not apparent in a woman of reproductive age who presents with edema, a disorder referred to as idiopathic edema should be considered. This disorder, which is often intermittent, causes fluid to accumulate when the patient is upright. Because of this postural relationship, research into pathogenesis has focused on homeostatic adjustments to changes in posture. A number of mechanisms have been proposed, the most tenable of which seem to be increased capillary permeability, increased mineralocorticoid activity, and a faulty "escape mechanism." The diagnosis of idiopathic edema is established by documenting an excessive intradiem weight gain (greater than 1 kg) and performing a water-loading test. Because the pathogenesis remains obscure, no specific or uniformly successful therapy yet exists. Besides recumbency, restriction of calories, sodium, and fluids may be tried. If these measures do not bring adequate relief, diuretics or sympathomimetics may be prescribed.
对于出现水肿的育龄女性，若未发现明显的毛细血管或肾脏病变，则应考虑一种称为特发性水肿的病症。这种病症通常呈间歇性，患者直立时会导致液体潴留。由于存在这种体位关系，发病机制的研究主要集中在对体位变化的稳态调节方面。已经提出了多种机制，其中最合理的似乎是毛细血管通透性增加、盐皮质激素活性增强以及“逃逸机制”存在缺陷。特发性水肿的诊断是通过记录日间体重过度增加（超过1千克）并进行水负荷试验来确立的。由于发病机制仍不清楚，目前尚无特效或一致有效的治疗方法。除了卧床休息外，还可以尝试限制热量、钠和液体的摄入。如果这些措施不能带来足够的缓解，可以使用利尿剂或拟交感神经药。
