妊娠中の女性における抗トロンビン活性と血漿アルドステロン濃度および血漿レニン活性との関連

目的：妊娠後期中の血液抗トロンビン（AT）活性が血漿アルドステロン濃度（PAC）、血漿レニン活性（PRA）、および/またはPAC対PRA比と相関しているという仮説をテストする。 方法：AT活動、PAC、およびPRAは、47人の女性の出産の7日以内に決定され、30人の正常血圧と6人の高血圧性の女性と双子の妊娠を持つ11人の正常血圧女性で構成されました。 結果：47人の女性の値の中央値は、AT活動では通常の活動レベルの86％、PACで442 pg/ml、PRAで3.7 ng/ml/h、PAC対PAR比でng/ml/mあたり108 pg/mlでした。AT活性が86％以下の女性は、ATアクティビティを> 86％> 86％の女性よりも有意に低く、PACとPAC-PRA比が大きくなりました（PRAの場合3.5±3.0対6.6±4.7 ng/ml/h、P = 0.008;ATアクティビティは、PRAと正の相関があり、PAC対PAR-PRA比と否定的に相関していました。 結論：妊娠後期における活動時の減少とPRAの減少との間の一般的な病態生理学的背景の存在が示唆されました。

OBJECTIVE: To test the hypothesis that the blood antithrombin (AT) activity is correlated with the plasma aldosterone concentration (PAC), the plasma renin activity (PRA), and/or the PAC-to-PRA ratio during the late stage of pregnancy. METHODS: The AT activity, PAC, and PRA were determined within 7 days prior to delivery in 47 women, consisting of 30 normotensive and 6 hypertensive women with singleton pregnancies and 11 normotensive women with twin pregnancies. RESULTS: The median values of the 47 women were 86% of the normal activity level for the AT activity, 442 pg/mL for the PAC, 3.7 ng/mL/h for the PRA, and 108 pg/mL per ng/mL/h for the PAC-to-PRA ratio. Women with an AT activity ≤86% had a significantly lower PRA and a higher PAC-to-PRA ratio than women with an AT activity >86% (3.5 ± 3.0 vs. 6.6 ± 4.7 ng/mL/h for PRA, p = 0.008; 156 ± 109 vs. 97 ± 46 pg/mL per ng/h for PAC-to-PRA ratio, p = 0.021). The AT activity was significantly correlated positively with the PRA and negatively with the PAC-to-PRA ratio. CONCLUSIONS: The existence of a common pathophysiological background between a reduced AT activity and a reduced PRA during the late stage of pregnancy was suggested.