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关于妊娠期使用利尿剂的价值,在文献中存在着相互矛盾的观点。有人认为,预防性应用利尿剂,能降低妊娠中毒症的发病率及其严重程度,也能降低围产期死亡率,而另有人认为,用利尿剂无益反有害。然而,在有些地区半数以上孕妇,在孕期接受利尿剂治疗。已知噻嗪类利尿剂激活肾素——醛固酮系统。在作者早期研究中已证明妊娠能激活此系统。在孕30周,血浆肾素活性(PRA)约增7倍,而尿排泄的醛固酮与非妊娠相比约增13倍。本研究观察孕期利尿剂对肾素——醛固酮系统的影响,及其由妊娠提高的数值是否能进一步增加。
There are conflicting opinions in the literature on the value of using diuretics during pregnancy. Some people think that prophylactic diuretics can reduce the incidence and severity of gestosis, but also reduce perinatal mortality, while others believe that the use of diuretics is not harmful. However, in some areas more than half of pregnant women receive diuretics during pregnancy. Thiazide diuretics are known to activate the renin-aldosterone system. In an earlier study by the authors, pregnancy has been shown to activate this system. At 30 weeks of gestation, plasma renin activity (PRA) increased approximately 7-fold, whereas urinary excretion of aldosterone increased approximately 13-fold compared to non-pregnancy. This study examined the effect of diuretics during pregnancy on the renin-aldosterone system and whether its increased value from pregnancy can be further increased.