Beaufils M, Delauche M C, Morel-Maroger L, Leroux-Robert C, Richet G
Ann Med Interne (Paris). 1980;131(6):339-42.
Renal biopsy was performed in 125 patients with severe hypertension during pregnancy. Three groups could be defined: I: normal kidney; II: vascular lesions; III: nephropathy. The histological appearance could not be suspected from clinical criteria (age, parity, symptoms, date of appearance). About 70% of the patients in groups I and II had permanent metabolic disorders (mainly hypercholesterolemia) and had a familial history of hypertension. Recurrence of hypertension during subsequent pregnancies occurred in 70% of cases, identical in groups I and II, and therefore impossible to predict by histological findings. Permanent hypertension developed in 47% of group II patients and 8% of group I (p < 0.001). The authors conclude that hypertension during pregnancy affects a sub-population genetically selected and that renal biopsy is of little value for predicting the prognosis in future pregnancies. The indications for renal biopsy are discussed.
对125例妊娠期间患有严重高血压的患者进行了肾活检。可分为三组：I组：肾脏正常；II组：血管病变；III组：肾病。无法从临床标准（年龄、产次、症状、发病日期）推断出组织学表现。I组和II组中约70%的患者患有永久性代谢紊乱（主要是高胆固醇血症），并有高血压家族史。在随后的妊娠中，70%的病例出现高血压复发，I组和II组相同，因此无法通过组织学结果预测。II组47%的患者和I组8%的患者发展为永久性高血压（p<0.001）。作者得出结论，妊娠期间的高血压影响一个经基因选择的亚群，肾活检对预测未来妊娠的预后价值不大。文中讨论了肾活检的适应证。
