Bennett T L, Rose J C
Department of Obstetrics and Gynecology, University of Kansas School of Medicine, Kansas City.
Am J Obstet Gynecol. 1991 Dec;165(6 Pt 1):1627-34. doi: 10.1016/0002-9378(91)90006-d.
Isotonic volume expansion results in atrial natriuretic factor release by cardiac myocytes. Because pregnancy produces well-established alterations in fluid homeostasis and cardiovascular function, changes in atrial natriuretic factor responses may also occur. This study compares plasma atrial natriuretic factor responses to short-term volume expansion in pregnant and nonpregnant sheep. Seven pregnant and six nonpregnant ewes were chronically instrumented and subjected to a series of four experiments consisting of a control group (no infusion) and groups that received 10 ml/kg, 25 ml/kg, and 40 ml/kg isotonic saline infusion over a 30-minute period. The order of the experiments was random and separated by greater than or equal to 48 hours. Plasma atrial natriuretic factor, osmolality, right atrial pressure, blood pressure, and urine flow were measured over a 150-minute observation period. After volume expansion, plasma atrial natriuretic factor levels rose significantly from 39 +/- 4 pg/ml (mean +/- SEM) to 49 +/- 7 pg/ml, 36 +/- 4 pg/ml to 62 +/- 19 pg/ml, and 39 +/- 6 pg/ml to 67 +/- 14 pg/ml in the nonpregnant group 10 ml/kg, 25 ml/kg, and 40 ml/kg experiments, respectively. In the pregnant groups, plasma atrial natriuretic factor levels rose from 50 +/- 2 pg/ml to 75 +/- 20 pg/ml, 43 +/- 5 pg/ml to 57 +/- 5 pg/ml, and 46 +/- 4 pg/ml to 67 +/- 7 pg/ml, respectively. Differences in atrial natriuretic factor responses were not seen between pregnant and nonpregnant groups at any volume expansion level. As expected, atrial pressure and urine flow significantly increased after all volume expansion experiments. Pregnant and nonpregnant groups were similar with respect to atrial pressure and urine flow responses. Over various volume expansion levels significant associations were seen between atrial pressure, atrial natriuretic factor, and urine flow. These relationships were unaltered by pregnancy. In summary, atrial natriuretic factor responses to volume expansion do not appear to differ between pregnant and nonpregnant sheep.
等渗性容量扩张导致心肌细胞释放心钠素。由于妊娠会使体液平衡和心血管功能发生明确的改变,心钠素反应也可能会发生变化。本研究比较了妊娠和未妊娠绵羊对短期容量扩张的血浆心钠素反应。对7只妊娠母羊和6只未妊娠母羊进行长期仪器植入,并进行一系列四项实验,包括一个对照组(不输液)以及在30分钟内接受10 ml/kg、25 ml/kg和40 ml/kg等渗盐水输注的组。实验顺序是随机的,且间隔大于或等于48小时。在150分钟的观察期内测量血浆心钠素、渗透压、右心房压力、血压和尿流量。容量扩张后,未妊娠组在10 ml/kg、25 ml/kg和40 ml/kg实验中,血浆心钠素水平分别从39±4 pg/ml(平均值±标准误)显著升至49±7 pg/ml、从36±4 pg/ml升至62±19 pg/ml、从39±6 pg/ml升至67±14 pg/ml。在妊娠组中,血浆心钠素水平分别从50±2 pg/ml升至75±20 pg/ml、从43±5 pg/ml升至57±5 pg/ml、从46±4 pg/ml升至67±7 pg/ml。在任何容量扩张水平下,妊娠组和未妊娠组在心钠素反应上均未观察到差异。正如预期的那样,在所有容量扩张实验后,心房压力和尿流量显著增加。妊娠组和未妊娠组在心房压力和尿流量反应方面相似。在不同的容量扩张水平上,心房压力、心钠素和尿流量之间存在显著关联。这些关系不受妊娠的影响。总之,妊娠和未妊娠绵羊在心钠素对容量扩张的反应方面似乎没有差异。