Ortiz Luis A, Quan Albert, Zarzar Francisco, Weinberg Arthur, Baum Michel
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75235-9063, USA.
Hypertension. 2003 Feb;41(2):328-34. doi: 10.1161/01.hyp.0000049763.51269.51.
Dexamethasone is frequently administered to the developing fetus to accelerate pulmonary development. The purpose of the present study was to determine if prenatal dexamethasone programmed a progressive increase in blood pressure and renal injury in rats. Pregnant rats were given either vehicle or 2 daily intraperitoneal injections of dexamethasone (0.2 mg/kg body weight) on gestational days 11 and 12, 13 and 14, 15 and 16, 17 and 18, or 19 and 20. Offspring of rats administered dexamethasone on days 15 and 16 gestation had a 20% reduction in glomerular number compared with control at 6 to 9 months of age (22 527+/-509 versus 28 050+/-561, P<0.05), which was comparable to the percent reduction in glomeruli measured at 3 weeks of age. Six- to 9-month old rats receiving prenatal dexamethasone on days 17 and 18 of gestation had a 17% reduction in glomeruli (23 380+/-587) compared with control rats (P<0.05). Male rats that received prenatal dexamethasone on days 15 and 16, 17 and 18, and 13 and 14 of gestation had elevated blood pressures at 6 months of age; the latter group did not have a reduction in glomerular number. Adult rats given dexamethasone on days 15 and 16 of gestation had more glomeruli with glomerulosclerosis than control rats. This study shows that prenatal dexamethasone in rats results in a reduction in glomerular number, glomerulosclerosis, and hypertension when administered at specific points during gestation. Hypertension was observed in animals that had a reduction in glomeruli as well as in a group that did not have a reduction in glomerular number, suggesting that a reduction in glomerular number is not the sole cause for the development of hypertension.
地塞米松经常被用于发育中的胎儿,以加速肺部发育。本研究的目的是确定产前使用地塞米松是否会使大鼠血压逐渐升高并导致肾损伤。将怀孕大鼠分为两组,一组给予赋形剂,另一组在妊娠第11和12天、13和14天、15和16天、17和18天或19和20天每天腹腔注射两次地塞米松(0.2毫克/千克体重)。在妊娠第15和16天给予地塞米松的大鼠后代,在6至9个月龄时,肾小球数量比对照组减少了20%(22527±509对28050±561,P<0.05),这与3周龄时测量的肾小球减少百分比相当。在妊娠第17和18天接受产前地塞米松的6至9个月龄大鼠,其肾小球数量比对照大鼠减少了17%(23380±587)(P<0.05)。在妊娠第15和16天、17和18天以及13和14天接受产前地塞米松的雄性大鼠,在6个月龄时血压升高;后一组的肾小球数量没有减少。在妊娠第15和16天给予地塞米松的成年大鼠,与对照大鼠相比,有更多的肾小球出现肾小球硬化。这项研究表明,大鼠在妊娠特定阶段使用产前地塞米松会导致肾小球数量减少、肾小球硬化和高血压。在肾小球数量减少的动物以及肾小球数量未减少的一组动物中均观察到了高血压,这表明肾小球数量减少不是高血压发生的唯一原因。