Fadel H E, Northrop G, Misenhimer H R
Am J Obstet Gynecol. 1976 Jul 1;125(5):640-7. doi: 10.1016/0002-9378(76)90786-9.
Seventeen pre-eclamptic (PE), 22 hypertensive (H), and 13 normal pregnant women (C), all in the third trimester, were studied to examine the relationship of blood lactate (L) to the hyperuricemia characteristic of PE. The parameters measured were: serum and urinary uric acid, and creatinine, and lactate (L), and pyruvate (P) in the blood. Uric acid clearance (Cur), and creatinine clearance (Ccr), and fractional uric acid clearance (Fract. Cur) as well as L/P ratios were calculated. Some of the patients, from the three groups, were infused with approximately equal to 100 mEq. of sodium lactate during the course of 50 minutes. "Preinfusion," "midinfusion," and "postinfusion," determinations were compared, as well as the per cent change in the different parameters as the result of the infusion and after its discontinuation. The results showed that serum urine acid is elevated, and Cur is impaired in PE; however, L was lower in PE than in control subjects. There was no correlation between L or L/P and Cur. Lactate infusion caused comparable impairment of Cur in all groups. There was no significant difference in the response of the parameters studied, to the infusion, between the different groups. Our data cast serious doubts on the postulated role of blood lactate in the etiology of hyperuricemia in PE. Contracted plasma volume and/or local release of angiotensin II in the kidney of pre-eclamptic patients probably play a more important role.
对17名先兆子痫（PE）孕妇、22名高血压（H）孕妇和13名正常妊娠晚期孕妇（C）进行了研究，以探讨血乳酸（L）与PE的高尿酸血症特征之间的关系。所测量的参数包括：血清和尿尿酸、肌酐、血液中的乳酸（L）和丙酮酸（P）。计算尿酸清除率（Cur）、肌酐清除率（Ccr）、尿酸分数清除率（Fract. Cur）以及L/P比值。三组中的一些患者在50分钟内输注了约100 mEq的乳酸钠。比较了“输注前”、“输注中”和“输注后”的测定结果，以及输注及其停止后不同参数的变化百分比。结果显示，PE患者血清尿酸升高，Cur受损；然而，PE患者的L低于对照组。L或L/P与Cur之间无相关性。乳酸输注在所有组中均导致Cur出现类似程度的受损。不同组之间，所研究的参数对输注的反应无显著差异。我们的数据对血乳酸在PE高尿酸血症病因中所假定的作用提出了严重质疑。先兆子痫患者肾脏中血浆容量收缩和/或血管紧张素II的局部释放可能起更重要的作用。
