Bussen S S, Sütterlin M W, Steck T
Department of Obstetrics and Gynecology, The University of Würzburg, Germany.
Acta Obstet Gynecol Scand. 1998 Jul;77(6):609-13. doi: 10.1034/j.1600-0412.1998.770606.x.
To investigate plasma renin activity and aldosterone serum concentrations in severe preeclampsia (PE) or HELLP-syndrome.
We measured plasma renin activity and serum concentrations of aldosterone, progesterone, estradiol and estriol in 16 patients with PE and 14 patients with HELLP-syndrome and in well-matched normotensive pregnant controls. Additionally, the umbilical venous levels of aldosterone and plasma renin activity were determined in ten corresponding newborns.
Serum aldosterone levels as well as plasma renin activity were significantly lower in patients with PE but not in women with HELLP-syndrome when compared to controls. We did not find any relationship either between aldosterone serum concentration or plasma renin activity and progesterone, estradiol or estriol levels in PE or in the HELLP-syndrome. Umbilical venous renin activity and aldosterone levels were higher than in maternal blood, but there were no significant differences in the umbilical venous levels between normotensive pregnancies and pregnancies complicated by either severe PE or HELLP-syndrome.
It is concluded that in patients with PE well-known changes in the renin-angiotensin-aldosterone system cannot be found in patients with HELLP- syndrome. This finding is not related to alterations in sex steroid levels.
研究重度子痫前期（PE）或HELLP综合征患者的血浆肾素活性及醛固酮血清浓度。
我们测定了16例PE患者、14例HELLP综合征患者以及血压正常的匹配良好的孕妇对照组的血浆肾素活性、醛固酮、孕酮、雌二醇和雌三醇的血清浓度。此外，还测定了10例相应新生儿的脐静脉醛固酮水平和血浆肾素活性。
与对照组相比，PE患者的血清醛固酮水平和血浆肾素活性显著降低，但HELLP综合征患者未出现此情况。在PE或HELLP综合征患者中，我们未发现醛固酮血清浓度或血浆肾素活性与孕酮、雌二醇或雌三醇水平之间存在任何关联。脐静脉肾素活性和醛固酮水平高于母体血液，但血压正常的妊娠与合并重度PE或HELLP综合征的妊娠的脐静脉水平无显著差异。
得出结论，在PE患者中发现的肾素-血管紧张素-醛固酮系统的常见变化在HELLP综合征患者中未出现。这一发现与性类固醇水平的改变无关。
