雌激素和孕激素的影响renin-aldosterone系统和血压。
文章的细节
-
引用
复制到剪贴板 -
Oelkers工作
雌激素和孕激素的影响renin-aldosterone系统和血压。
类固醇。1996年4月,61 (4):166 - 71。
- PubMed ID
-
8732994 (在PubMed]
- 文摘
-
内生17 beta雌二醇(E2)和较低的注射用药物的剂量的外源性E2血管舒张。高剂量雌激素,尤其是炔雌醇(EE)和炔雌醇甲醚,刺激肝蛋白质包括凝血因子的合成,性激素结合球蛋白,血管紧张肽原(Aogen)。在稳定状态下,高血浆水平Aogen只产生很小的增加血浆肾素血管紧张素ⅱ(暗)和活动,因为还能抑制肾素的分泌,降低血浆肾素浓度。然而,一切皆满足的增加略有减少肾血流量和交换钠和血压略有增加;在敏感的女性,血压可能会显著上升。雌激素对大脑的影响也可能参与了血压的变化。内源性孕酮是一种盐皮质激素受体拮抗剂。内源性或外源性孕激素导致钠流失和补充肾素分泌增加,血浆肾素活性,暗生,下半年和血浆醛固酮,如月经周期。合成孕激素通常缺乏盐皮质激素受体拮抗孕激素的影响,和一些弱的雌激素受体受体激动剂。结合使用EE和合成孕激素可能会因此提高雌性激素对身体钠和血压的影响。 A new progestogen (Drospirenone) with an antimineralocorticoid effect like that of progesterone is described that slightly lowers body weight and blood pressure in a contraceptive formulation together with EE. An almost ideal oral contraceptive would be progestogen like Drospirenone together with a low dose natural estrogen that does not stimulate Aogen synthesis. Since most oral formulations for postmenopausal estrogen replacement also stimulate hepatic protein synthesis (including Aogen) to some extent, the transdermal route of E2 application for contraceptive purposes should also be investigated, since it has reduced potential for undesirable side effects.