Motoyama S, Mochizuki M, Tojo S
Acta Obstet Gynaecol Jpn. 1980 Dec;32(12):1977-85.
Systematical determination of renin activity (PRA) and aldosterone concentration (PA) in blood of normal and hypertensive pregnant women was done. At the same time, reactive change of PRA and PA to NaCl loading was studied, and the authors gained the following conclusions: 1) In normal pregnant women a significant increase was observed respectively in PRA and PA in comparison with those observed in non-pregnant status (PRA: P less than 0.05, PA: P less than 0.02). A peak (11.85 ng/ml/hr) was formed in PRA at the 32nd week of pregnancy, while in PA an increase lasted until the start of labour, attaining a level of 563.3 pg/ml (mean value). 2) PRA and PA in toxemia of pregnancy were obviously lower in comparison with normal pregnancy in the corresponding period. Analysis by the two dimensional cordinate system in which PA value was represented by axis of abscissas and PRA value by axis of ordinate disclosed that hypertensive toxemia of pregnancy tended to be distributed among patients with low PRA while non-hypertensive toxemia of pregnancy was distributed among patients with low PA. 3) In non-pregnant women and those in the first trimester, no noticeable change was displayed by NaCl load either in PRA or in PA, but the reactivity became obvious along with advancement of pregnancy and a high reactivity was shown by pregnant women who were positive in the so-called roll-over test. Also when women whose blood pressure rose to 140/90 mmHg or above after NaCl loading were classified as those positive in NaCl loading test, all the normal pregnant women were negative, but among the patients with hypertensive pregnancy, a positive reaction was represented in half of them in spite of the treatment. The above signifies that the PRA and PA were different in their behaviors in the third trimester, and in the value of PA, participation of aldosterone deriving from fetus was suggested. Analysis of PRA and PA by the two dimensional cordinate system and analysis of the behavioral reaction in NaCl loading test were supposed to be clinically useful for classification of the clinico-pathological types of toxemia of pregnancy.
对正常孕妇和高血压孕妇的血液肾素活性（PRA）和醛固酮浓度（PA）进行了系统测定。同时，研究了PRA和PA对氯化钠负荷的反应性变化，作者得出以下结论：1）与非孕期相比，正常孕妇的PRA和PA分别显著升高（PRA：P＜0.05，PA：P＜0.02）。妊娠32周时PRA形成峰值（11.85ng/ml/hr），而PA持续升高直至分娩开始，达到563.3pg/ml（平均值）。2）妊娠中毒症患者的PRA和PA明显低于同期正常妊娠者。以PA值为横坐标、PRA值为纵坐标的二维坐标系分析显示，妊娠高血压中毒症倾向于分布在PRA低的患者中，而非高血压妊娠中毒症分布在PA低的患者中。3）在非孕妇和孕早期妇女中，氯化钠负荷对PRA或PA均无明显变化，但随着孕周增加反应性变得明显，在所谓的翻转试验中呈阳性的孕妇表现出高反应性。此外，当将氯化钠负荷后血压升至140/90mmHg及以上的妇女归类为氯化钠负荷试验阳性者时，所有正常孕妇均为阴性，但在高血压妊娠患者中，尽管接受了治疗，仍有一半表现为阳性反应。上述情况表明，孕晚期PRA和PA的行为不同，并且在PA值方面，提示有来自胎儿的醛固酮参与。通过二维坐标系对PRA和PA进行分析以及对氯化钠负荷试验中的行为反应进行分析，在临床上可能有助于对妊娠中毒症的临床病理类型进行分类。
