Segar Jeffrey L, Van Natta Timothy, Smith Oliva J
Department of Pediatrics, Cardiovascular Center, University of Iowa, Iowa City, Iowa 52242, USA.
Am J Physiol Regul Integr Comp Physiol. 2002 Aug;283(2):R460-7. doi: 10.1152/ajpregu.00056.2002.
Studies were performed to test the hypothesis that the absence of adrenal glucocorticoids late in gestation alters sympathetic and baroreflex responses before and immediately after birth. Fetal sheep at 130-131 days gestation (term 145 days) were subjected to bilateral adrenalectomy before the normal prepartum increase in plasma cortisol levels. One group of fetuses (n = 5) received physiological cortisol replacement with a continuous infusion of hydrocortisone (2 mg x day(-1) x kg(-1) for 10 days), whereas the other group received 0.9% NaCl vehicle (n = 5). All animals underwent a second surgery 48 h before the study for placement of a renal nerve recording electrode. Heart rate (HR), mean arterial blood pressure (MABP), renal sympathetic nerve activity (RSNA), and baroreflex control of HR and RSNA were studied before and after cesarean section delivery. At the time of study (140-141 days gestation), fetal plasma cortisol concentration was undetectable in adrenalectomized (ADX) fetuses and 58 +/- 9 ng/ml in animals receiving cortisol replacement (ADX + F). Fetal and newborn MABP was significantly greater in ADX + F relative to ADX animals. One hour after delivery, MABP increased 13 +/- 3 mmHg and RSNA increased 91 +/- 12% above fetal values in ADX + F (both P < 0.05) but remained unchanged in ADX lambs. The midpoint pressures of the fetal HR and RSNA baroreflex function curves were significantly greater in ADX + F (54 +/- 3 and 56 +/- 3 mmHg for HR and RSNA curves, respectively) than ADX fetuses (45 +/- 2 and 46 +/- 3 mmHg). After delivery, the baroreflex curves reset toward higher pressure in ADX + F but not ADX lambs. These results suggest that adrenal glucocorticoids contribute to cardiovascular regulation in the late-gestation fetus and newborn by modulating arterial baroreflex function and sympathetic activity.
妊娠后期肾上腺糖皮质激素缺乏会改变出生前及出生后即刻的交感神经和压力反射反应。妊娠130 - 131天(足月为145天)的胎羊在血浆皮质醇水平正常的产前升高之前接受双侧肾上腺切除术。一组胎儿(n = 5)通过持续输注氢化可的松(2 mg·天⁻¹·kg⁻¹,持续10天)接受生理剂量的皮质醇替代,而另一组接受0.9%氯化钠载体溶液(n = 5)。所有动物在研究前48小时接受第二次手术,以放置肾神经记录电极。在剖宫产分娩前后研究心率(HR)、平均动脉血压(MABP)、肾交感神经活动(RSNA)以及HR和RSNA的压力反射控制。在研究时(妊娠140 - 141天),肾上腺切除(ADX)胎儿的胎儿血浆皮质醇浓度检测不到,而接受皮质醇替代的动物(ADX + F)中为58±9 ng/ml。相对于ADX动物,ADX + F中的胎儿和新生羊的MABP显著更高。分娩后1小时,ADX + F中的MABP比胎儿值升高了13±3 mmHg,RSNA升高了91±12%(均P < 0.05),但ADX羔羊中保持不变。ADX + F中胎儿HR和RSNA压力反射功能曲线的中点压力(HR曲线和RSNA曲线分别为54±3和56±3 mmHg)显著高于ADX胎儿(45±2和46±3 mmHg)。分娩后,ADX + F中的压力反射曲线向更高压力重置,而ADX羔羊则不然。这些结果表明,肾上腺糖皮质激素通过调节动脉压力反射功能和交感神经活动,对妊娠后期胎儿和新生儿的心血管调节起作用。