Parker C R, Everett R B, Whalley P J, Quirk J G, Gant N F, MacDonald P C
Am J Obstet Gynecol. 1980 Nov 15;138(6):626-31.
The plasma concentration of deoxycorticosterone (DOC) was determined serially in a large group of primigravid women from 10 weeks' gestation to term. The plasma level of DOC in women whose pregnancies were uncomplicated (n = 44) was 234 +/- 33 pg/ml (mean +/- SE), at 10 to 14 weeks' gestation, a level two times that of nonpregnant subjects. The plasma level of DOC in these women rose to 778 +/- 65 pg/ml at 23 to 26 weeks' gestation, and at term (39 to 42 weeks) was 1,309 +/- 155 pg/ml. The plasma levels of DOC in women (n = 31) who eventually developed pregnancy-induced hypertension (PIH) were similar to those in the women who remained normal at all stages of pregnancy. We also found that, in women with normal pregnancies as well as in all stages of pregnancy. We also found that, in women with normal pregnancies as well as in women destined to develop PIH, the plasma concentration of DOC fluctuated in a manner parallel to that of progesterone throughout gestation; however, changes in the plasma level of DOC did not mirror those of cortisol. These data suggest that excessive plasma levels of DOC are not necessarily associated with the development of PIH. These data also support the view that, in pregnant women, a fraction of circulating DOC may arise via extra-adrenal 21-hydroxylation of progesterone rather than through adrenal secretion.
对一大组初孕妇从妊娠10周直至足月连续测定脱氧皮质酮(DOC)的血浆浓度。妊娠过程无并发症的妇女(n = 44)在妊娠10至14周时,DOC的血浆水平为234±33 pg/ml(均值±标准误),是非妊娠受试者的两倍。这些妇女的DOC血浆水平在妊娠23至26周时升至778±65 pg/ml,足月时(39至42周)为1309±155 pg/ml。最终发生妊娠高血压综合征(PIH)的妇女(n = 31)的DOC血浆水平与整个孕期保持正常的妇女相似。我们还发现,在妊娠正常的妇女以及妊娠各阶段,在妊娠正常的妇女以及注定要发生PIH的妇女中,整个孕期DOC的血浆浓度与孕酮的波动方式平行;然而,DOC血浆水平的变化并不反映皮质醇的变化。这些数据表明,DOC血浆水平过高不一定与PIH的发生有关。这些数据还支持这样一种观点,即孕妇体内一部分循环的DOC可能是通过孕酮的肾上腺外21-羟化作用产生的,而不是通过肾上腺分泌产生的。