Everett R B, Worley R J, MacDonald P C, Gant N F
Am J Obstet Gynecol. 1978 Jun 15;131(4):352-7. doi: 10.1016/0002-9378(78)90407-6.
In gravid women who are destined to develop pregnancy-induced hypertension (PIH), normal pregnancy-associated refractoriness to the pressor effects of administered angiotensin II (A-II) is lost several weeks before the onset of hypertension. From a study of the determinants of A-II pressor responsiveness in normal gravid women, it appears likely that the loss of resistance to A-II is principally unrelated to plasma renin activity or to plasma A-II levels. However, it recently has been shown that the vascular refractoriness to A-II in normal women can be reduced significantly by the administration of the prostaglandin synthetase inhibitors, indomethacin or aspirin. In seven women who had developed PIH and who had lost their refractoriness to A-II, the infusion of 5alpha-pregnan-3,20-dione (5alpha-DHP) was associated with restoration of refractoriness to the pressor effects of A-II. Moreover, in five normotensive gravid women beyond 28 weeks' gestation in whom the refractoriness to A-II was reduced by the administration of indomethacin, the intravenous infusion of 5alpha-DPH was associated with restoration of refractoriness to the pressor effects of A-II. These observations are consistent with the view that a progesterone metabolite(s) may be important in the maintenance of normal blood pressure during human pregnancy.
在注定要发生妊娠高血压综合征（PIH）的孕妇中，在高血压发作前几周，正常妊娠时对给予的血管紧张素II（A-II）升压作用的抵抗性就会丧失。通过对正常妊娠女性A-II升压反应性决定因素的研究，对A-II的抵抗性丧失似乎主要与血浆肾素活性或血浆A-II水平无关。然而，最近有研究表明，给予前列腺素合成酶抑制剂吲哚美辛或阿司匹林可显著降低正常女性对A-II的血管抵抗性。在7名已发生PIH且对A-II失去抵抗性的女性中，输注5α-孕烷-3,20-二酮（5α-DHP）可恢复对A-II升压作用的抵抗性。此外，在5名妊娠28周以上的血压正常孕妇中，给予吲哚美辛可降低其对A-II的抵抗性，静脉输注5α-DPH可恢复对A-II升压作用的抵抗性。这些观察结果与以下观点一致，即一种或多种孕酮代谢产物可能在维持人类妊娠期间的正常血压中起重要作用。
