Cuthrell W V, Rose J C, Meis P J
Department of Obstetrics and Gynecology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
Am J Obstet Gynecol. 1990 Jul;163(1 Pt 1):170-4. doi: 10.1016/s0002-9378(11)90693-0.
It is not known whether activation of the fetal adrenal gland can inhibit pituitary adrenal responses to stress. Therefore we treated 14 chronically cannulated sheep fetuses (gestational age range, 109 to 129 days) with an adrenocorticotropic hormone infusion of 5 ng/kg per minute or vehicle solution at similar rates for 2.5 hours and then subjected them to a 10-minute period of hypotension. Resting mean arterial blood pressures were similar for both control and adrenocorticotropic hormone infusion groups and decreased similarly after administration of sodium nitroprusside. Resting fetal plasma cortisol levels (11.6 +/- 3.3 ng/ml) and adrenocorticotropic hormone (42 +/- 15 pg/ml) concentrations were not different in the two groups. In the control group fetal plasma cortisol concentrations rose from 12.1 +/- 1.7 to 35.7 +/- 8.0 ng/ml after hypotension (p less than 0.05) and plasma adrenocorticotropic hormone increased from 37 +/- 19 to 145 +/- 67 pg/ml (p less than 0.05). In the group treated with adrenocorticotropic hormone, fetal plasma cortisol concentrations increased (30.2 +/- 7.8 to 53.6 +/- 15.0 ng/ml; p less than 0.05) after hypotension whereas fetal plasma adrenocorticotropic hormone concentrations did not increase (398 +/- 227 versus 258 +/- 77 pg/ml; p greater than 0.05).
尚不清楚胎儿肾上腺的激活是否会抑制垂体-肾上腺对应激的反应。因此，我们对14只长期插管的绵羊胎儿（胎龄范围为109至129天）以每分钟5 ng/kg的促肾上腺皮质激素输注或相似速率输注溶媒溶液，持续2.5小时，然后使它们经历10分钟的低血压期。对照组和促肾上腺皮质激素输注组的静息平均动脉血压相似，在给予硝普钠后下降情况也相似。两组的静息胎儿血浆皮质醇水平（11.6±3.3 ng/ml）和促肾上腺皮质激素（42±15 pg/ml）浓度无差异。在对照组中，低血压后胎儿血浆皮质醇浓度从12.1±1.7 ng/ml升至35.7±8.0 ng/ml（p<0.05），血浆促肾上腺皮质激素从37±19 pg/ml增至145±67 pg/ml（p<0.05）。在接受促肾上腺皮质激素治疗的组中，低血压后胎儿血浆皮质醇浓度升高（从30.2±7.8 ng/ml升至53.6±15.0 ng/ml；p<0.05），而胎儿血浆促肾上腺皮质激素浓度未升高（398±227 pg/ml对258±77 pg/ml；p>0.05）。
