Wood C E, Chen H G, Bell M E
Department of Physiology, University of Florida College of Medicine, Gainesville 32610.
Circ Res. 1989 Mar;64(3):515-23. doi: 10.1161/01.res.64.3.515.
Hemorrhage stimulates endocrine and cardiovascular reflex responses that are appropriate for returning blood volume and pressure to prehemorrhage levels. Fetal sheep respond to hemorrhage with increases in plasma adrenocorticotropic hormone (ACTH), cortisol, and vasopressin concentrations and plasma renin activity, but little is known about the afferent limb of the reflex(es) controlling these responses. Fetal sheep between 128 and 133 days' gestation were chronically prepared with vascular catheters. Five fetal sheep were subjected to bilateral section of the cervical vagosympathetic trunks; six fetal sheep were not vagotomized. Four to six days after surgery, the fetuses were subjected to withdrawal of 10 ml of blood every 10 minutes for 2 hours (130 ml total). Vagotomized fetal sheep responded to the hemorrhage with a greater decrease in central venous pressure than the intact fetuses and a slower restitution of fluid to the vascular space (estimated to be 17% of the hemorrhage volume in 2 hours) than the intact fetuses (estimated to be 28% of the hemorrhage volume in 2 hours). Both groups of fetuses, however, responded to the hemorrhage with increases in fetal plasma ACTH, cortisol, and vasopressin concentrations and plasma renin activity that were not significantly different. A posteriori analysis of the data by correlation analysis revealed that the fetal ACTH, vasopressin, and renin responses to the hemorrhage were more highly correlated to the changes in fetal arterial pH than to changes in fetal mean arterial pressure or central venous pressure. The results suggest that the ACTH, vasopressin, and renin responses to hemorrhage in the fetus be mediated by chemoreceptors, not by cardiovascular mechanoreceptors.(ABSTRACT TRUNCATED AT 250 WORDS)
出血会刺激内分泌和心血管反射反应,这些反应有助于将血容量和血压恢复到出血前的水平。胎羊对出血的反应是血浆促肾上腺皮质激素(ACTH)、皮质醇、血管加压素浓度以及血浆肾素活性增加,但对于控制这些反应的反射传入支了解甚少。对妊娠128至133天的胎羊长期植入血管导管。5只胎羊进行双侧颈迷走交感干切断术;6只胎羊未行迷走神经切断术。术后4至6天,对胎儿每10分钟抽取10ml血液,共抽取2小时(总量130ml)。与未行迷走神经切断术的胎儿相比,行迷走神经切断术的胎羊对出血的反应是中心静脉压下降幅度更大,液体恢复到血管内的速度更慢(估计2小时内为出血量的17%),而未行迷走神经切断术的胎儿(估计2小时内为出血量的28%)。然而,两组胎儿对出血的反应都是胎儿血浆ACTH、皮质醇、血管加压素浓度以及血浆肾素活性增加,且差异无统计学意义。通过相关分析对数据进行事后分析发现,胎儿对出血时ACTH、血管加压素和肾素的反应与胎儿动脉pH值的变化相关性更高,而不是与胎儿平均动脉压或中心静脉压的变化相关性更高。结果表明,胎儿对出血时ACTH、血管加压素和肾素的反应是由化学感受器介导的,而非心血管机械感受器。(摘要截短于250字)