Chapman A B, Zamudio S, Woodmansee W, Merouani A, Osorio F, Johnson A, Moore L G, Dahms T, Coffin C, Abraham W T, Schrier R W
University of Colorado Health Sciences Center, Denver 80262, USA.
Am J Physiol. 1997 Nov;273(5):F777-82. doi: 10.1152/ajprenal.1997.273.5.F777.
Blood pressure decreases during early pregnancy in association with a decrease in peripheral vascular resistance and increases in renal plasma flow and glomerular filtration rate. These early changes suggest a potential association with corpora lutea function. To determine whether peripheral vasodilation occurs following ovulation, we studied 16 healthy women in the midfollicular and midluteal phases of the menstrual cycle. A significant decrease in mean arterial pressure in the midluteal phase of the cycle (midfollicular of 81.7 +/- 2.0 vs. midluteal of 75.4 +/- 2.3 mmHg, P < 0.005) was found in association with a decrease in systemic vascular resistance and an increase in cardiac output. Renal plasma flow and glomerular filtration rate increased. Plasma renin activity and aldosterone concentration increased significantly in the luteal phase accompanied by a decrease in atrial natriuretic peptide concentration. Serum sodium, chloride, and bicarbonate concentrations and osmolarity also declined significantly in the midluteal phase of the menstrual cycle. Urinary adenosine 3',5'-cyclic monophosphate (cAMP) excretion increased in the luteal compared with the follicular phase, whereas no changes in urinary cGMP or NO2/NO3 excretion were found. Thus peripheral vasodilation occurs in the luteal phase of the normal menstrual cycle in association with an increase in renal plasma flow and filtration. Activation of the renin-angiotensin-aldosterone axis is found in the luteal phase of the menstrual cycle. These changes are accompanied by an increase in urinary cAMP excretion indicating potential vasodilating mediators responsible for the observed hemodynamic changes.
在妊娠早期，血压会随着外周血管阻力的降低以及肾血浆流量和肾小球滤过率的增加而下降。这些早期变化提示可能与黄体功能有关。为了确定排卵后是否会发生外周血管舒张，我们对16名处于月经周期卵泡期中期和黄体期中期的健康女性进行了研究。发现月经周期黄体期中期平均动脉压显著降低（卵泡期中期为81.7±2.0 mmHg，黄体期中期为75.4±2.3 mmHg，P<0.005），同时伴有全身血管阻力降低和心输出量增加。肾血浆流量和肾小球滤过率增加。黄体期血浆肾素活性和醛固酮浓度显著升高，同时心房利钠肽浓度降低。月经周期黄体期中期血清钠、氯、碳酸氢盐浓度和渗透压也显著下降。与卵泡期相比，黄体期尿中3',5'-环磷酸腺苷（cAMP）排泄增加，而尿中cGMP或NO2/NO3排泄无变化。因此，在正常月经周期的黄体期会发生外周血管舒张，同时伴有肾血浆流量和滤过增加。在月经周期的黄体期发现肾素-血管紧张素-醛固酮轴被激活。这些变化伴随着尿中cAMP排泄增加，表明存在可能导致所观察到的血流动力学变化的血管舒张介质。
