Zubrow A B, Daniel S S, Stark R I, Husain M K, James L S
Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, New York.
Pediatr Res. 1988 Jul;24(1):73-8. doi: 10.1203/00006450-198807000-00018.
The release of vasopressin, renin, and catecholamines by the fetus during either maternal or fetal hypotension was examined in chronically catheterized fetal lambs. Nitroprusside was infused intravenously for 1 h into seven pregnant ewes (maternal hypotension) or nine fetal lambs (fetal hypotension); the rates were adjusted to achieve a 15 to 30% decrease in mean blood pressure. During maternal hypotension, mean +/- SE vasopressin in maternal plasma increased from 1.2 +/- 0.2 pg.ml-1 to 208 +/- 153 pg.ml-1 and plasma renin activity increased from 1.5 +/- 0.3 ng.ml-1.h-1 to 6.6 +/- 1.6 ng.ml-1.h-1. Fetal vasopressin and plasma renin activity also increased during the same interval from 1.1 +/- 0.3 to 16.9 +/- 7.5 pg.ml-1 and 3.7 +/- 1.1 to 10.5 +/- 2.85 ng.ml-1.h-1, respectively; but no changes were observed in fetal blood pressure, heart rate, or acid base status. During fetal hypotension, mean vasopressin in fetal plasma increased from 4.3 +/- 3.4 pg.ml-1 to 1054 +/- 772 pg.ml-1, plasma renin activity increased from 5.7 +/- 2.2 ng.ml-1 to 22.2 +/- 7.1 ng.ml-1.h-1, and total catecholamines from 174 +/- 58 pg.ml-1 to 810 +/- 416 pg.ml-1. There was no change in fetal heart rate, acid base status, osmolality, or sodium concentration. The fetus became and remained hypertensive for at least 1 h after the end of infusion. This prolonged hypertension was associated with elevated levels of vasopressin and plasma renin activity. Peak vasopressin levels were proportional to the total nitroprusside dose in both the ewe and fetus (maternal r = 0.796, fetus r = 0.870).(ABSTRACT TRUNCATED AT 250 WORDS)
在慢性插管的胎羊中,研究了母体或胎儿低血压期间胎儿血管加压素、肾素和儿茶酚胺的释放情况。向7只怀孕母羊(母体低血压)或9只胎羊(胎儿低血压)静脉输注硝普钠1小时;调整输注速率以使平均血压降低15%至30%。在母体低血压期间,母体血浆中血管加压素的均值±标准误从1.2±0.2 pg/ml-1增加到208±153 pg/ml-1,血浆肾素活性从1.5±0.3 ng/ml-1·h-1增加到6.6±1.6 ng/ml-1·h-1。在相同时间段内,胎儿血管加压素和血浆肾素活性也分别从1.1±0.3增加到16.9±7.5 pg/ml-1以及从3.7±1.1增加到10.5±2.85 ng/ml-1·h-1;但胎儿血压、心率或酸碱状态未观察到变化。在胎儿低血压期间,胎儿血浆中血管加压素均值从4.3±3.4 pg/ml-1增加到1054±772 pg/ml-1,血浆肾素活性从5.7±2.2 ng/ml-1增加到22.2±7.1 ng/ml-1·h-1,总儿茶酚胺从174±58 pg/ml-1增加到810±416 pg/ml-1。胎儿心率、酸碱状态、渗透压或钠浓度没有变化。输注结束后,胎儿至少1小时内血压升高并持续。这种持续性高血压与血管加压素和血浆肾素活性水平升高有关。母羊和胎儿中血管加压素峰值水平与硝普钠总剂量成正比(母羊r = 0.796,胎儿r = 0.870)。(摘要截断于250字)