Paulick R P, Meyers R L, Rudolph C D, Rudolph A M
Cardiovascular Research Institute, University of California, San Francisco 94143.
Am J Physiol. 1991 Apr;260(4 Pt 2):H1205-13. doi: 10.1152/ajpheart.1991.260.4.H1205.
Acute fetal hypoxemia increases the vascular resistance of the umbilical veins as well as that of the liver. Because, at least in the human, the umbilical-placental circulation has no autonomic innervation, circulating hormones could well be responsible for this increase in umbilical-placental outflow resistance. In chronically instrumented fetal sheep, norepinephrine, epinephrine, vasopressin, and angiotensin II were infused in sequentially increasing doses into the descending aorta and vascular resistance to umbilical-placental blood flow was measured. Norepinephrine and epinephrine increased the vascular resistance of the umbilical veins in a dose-dependent manner. Both catecholamines also increased the vascular resistance of the liver, resulting in an increase in ductus venosus blood flow. In contrast, vasopressin and angiotensin II had no effect on umbilical-placental outflow resistance. Thus catecholamines may be responsible for the increase in the vascular resistance of the umbilical veins and liver in response to acute fetal hypoxemia.
急性胎儿低氧血症会增加脐静脉以及肝脏的血管阻力。因为,至少在人类中,脐-胎盘循环没有自主神经支配,循环激素很可能是脐-胎盘流出阻力增加的原因。在长期植入仪器的胎羊中,依次以递增剂量将去甲肾上腺素、肾上腺素、血管加压素和血管紧张素II注入降主动脉,并测量脐-胎盘血流的血管阻力。去甲肾上腺素和肾上腺素以剂量依赖的方式增加脐静脉的血管阻力。两种儿茶酚胺还会增加肝脏的血管阻力,导致静脉导管血流增加。相比之下,血管加压素和血管紧张素II对脐-胎盘流出阻力没有影响。因此,儿茶酚胺可能是导致急性胎儿低氧血症时脐静脉和肝脏血管阻力增加的原因。