Herin P, Kim J K, Schrier R W, Meschia G, Battaglia F C
Department of Pediatrics, University of Colorado School of Medicine, Denver 80262.
Q J Exp Physiol. 1988 Nov;73(6):931-40. doi: 10.1113/expphysiol.1988.sp003227.
The effect of maternal hyperosmolality as created by an acute mannitol infusion was evaluated in eight chronic sheep preparations. Fetal osmotic and haemodynamic responses were compared to those achieved during an arginine vasopressin (AVP) infusion into the fetus (approximately 400 microU/(min kg]. To assess the AVP sensitivity of the fetal kidney the urine osmolality was determined. The activity of adenylate cyclase was measured in placental cotyledons as an indicator of AVP receptors affecting water permeability. The maternal mannitol infusion induced an increase in fetal serum AVP levels from 1.18 +/- 0.25 up to 13.76 +/- 2.11 pg/ml. During the fetal AVP infusion the AVP levels were approximately 22 pg/ml, somewhat higher when given concurrently with a mannitol infusion to the ewe (peak value: 26.13 +/- 2.80 pg/ml). Fetal heart rate increased significantly during maternal hyperosmolality while this effect was blunted by exogenous AVP given to the fetus. The AVP infusion did not affect fetal or maternal serum osmolality. During the mannitol infusion fetal serum osmolality increased to peak values which were not significantly different whether or not AVP was infused into the fetus (from 298.0 +/- 0.85 to 309.0 +/- 0.90, and from 297.7 +/- 1.47 to 307.9 +/- 0.90 mosmol/kg, respectively). Similarly, there were no differences in the effect of mannitol infusion upon fetal urine osmolality with or without AVP infusion (increments: + 149.7 +/- 34.12 and + 148.7 +/- 31.30 mosmol/kg, respectively). Adenylate cyclase activity in the placenta was unchanged before and after AVP stimulation. The data suggest an unresponsiveness of placental water permeability to fetal AVP infusion. We also conclude that a maximal urine osmolality was reached already at AVP levels obtained after an osmotic maternal load whereas at AVP levels more than twice as high the cardiovascular effects were still AVP dose-dependent.
在八只慢性绵羊实验模型中评估了急性输注甘露醇所导致的母体高渗状态的影响。将胎儿的渗透和血流动力学反应与向胎儿输注精氨酸加压素(AVP,约400微单位/(分钟·千克))时所达到的反应进行比较。为评估胎儿肾脏对AVP的敏感性,测定了尿渗透压。测量胎盘子叶中腺苷酸环化酶的活性,作为影响水通透性的AVP受体的指标。母体输注甘露醇使胎儿血清AVP水平从1.18±0.25皮克/毫升升高至13.76±2.11皮克/毫升。在向胎儿输注AVP期间,AVP水平约为22皮克/毫升,当与向母羊输注甘露醇同时进行时略高(峰值:26.13±2.80皮克/毫升)。母体高渗状态期间胎儿心率显著增加,而向胎儿给予外源性AVP可减弱这种效应。输注AVP未影响胎儿或母体血清渗透压。在输注甘露醇期间,胎儿血清渗透压升高至峰值,无论是否向胎儿输注AVP,峰值均无显著差异(分别从298.0±0.85升至309.0±0.90,以及从297.7±1.47升至307.9±0.90毫摩尔/千克)。同样,无论是否输注AVP,输注甘露醇对胎儿尿渗透压的影响均无差异(增加值分别为+149.7±34.12和+148.7±31.30毫摩尔/千克)。AVP刺激前后胎盘腺苷酸环化酶活性未改变。数据表明胎盘水通透性对向胎儿输注AVP无反应。我们还得出结论,在母体渗透性负荷后获得的AVP水平时已达到最大尿渗透压,而在AVP水平高出两倍以上时,心血管效应仍呈AVP剂量依赖性。