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发育过程中肾脏对低氧血症的血流动力学反应:与循环血管活性物质的关系。

Renal hemodynamic responses to hypoxemia during development: relationships to circulating vasoactive substances.

作者信息

Weismann D N, Robillard J E

机构信息

Department of Pediatrics, University of Iowa, Iowa City 52242.

出版信息

Pediatr Res. 1988 Feb;23(2):155-62. doi: 10.1203/00006450-198802000-00004.

Abstract

Chronically catheterized fetal lambs (n = 11, gestational age 111-139 days) and neonatal lambs (n = 20, postnatal age 4-30 days) were studied to explore during development the relationship of renal hemodynamic responses during hypoxemia to plasma epinephrine concentration (E), plasma norepinephrine concentration (NE), plasma arginine vasopressin concentration (AVP), and plasma renin activity (PRA). A low oxygen gas mixture (11.1 +/- 0.1% O2) was administered for 30 min to the pregnant ewe or neonatal lamb to induce hypoxemia with maintenance of normal arterial pCO2 and pH. Arterial blood pressure was recorded continuously and renal blood flow (RBF) was determined by the radiolabeled microsphere technique. Moderate hypoxemia (pO2 16 +/- 2 torr and 33 +/- 6 torr in fetus and neonate, respectively) induced increases in E, NE (measured by radioenzymatic assay), and AVP (measured by radioimmunoassay) in both fetus and neonate. PRA (measured by radioimmunoassay) also increased in response to hypoxemia in neonatal lambs. The change in mean arterial pressure with hypoxemia (delta MAP) was significant in fetuses (delta MAP 8 +/- 14%, p less than 0.05) but not in lambs (delta MAP 1 +/- 10%, p greater than 0.5). Similarly, the change in renal blood flow with hypoxemia (delta RBF) was significant (delta RBF -51 +/- 24%, p less than 0.001) in fetuses but not in neonatal lambs (delta RBF -9 +/- 38%, p greater than 0.1). These results reflected a change in renal vascular resistance with hypoxemia (delta RVR) that was significant in fetal lambs (delta RVR 169 +/- 168%, p less than 0.01) but not in neonatal lambs (delta RVR 51 +/- 180%, p greater than 0.2).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

研究了慢性插管的胎羊(n = 11,胎龄111 - 139天)和新生羊(n = 20,出生后4 - 30天),以探讨在发育过程中低氧血症时肾血流动力学反应与血浆肾上腺素浓度(E)、血浆去甲肾上腺素浓度(NE)、血浆精氨酸加压素浓度(AVP)和血浆肾素活性(PRA)之间的关系。向怀孕母羊或新生羊给予低氧气体混合物(11.1±0.1% O₂)30分钟以诱导低氧血症,同时维持正常的动脉pCO₂和pH。连续记录动脉血压,并通过放射性微球技术测定肾血流量(RBF)。中度低氧血症(胎儿和新生儿的pO₂分别为16±2 torr和33±6 torr)在胎儿和新生儿中均诱导E、NE(通过放射酶法测定)和AVP(通过放射免疫法测定)升高。新生羊的PRA(通过放射免疫法测定)也因低氧血症而升高。低氧血症时平均动脉压的变化(δMAP)在胎儿中显著(δMAP 8±14%,p < 0.05),但在新生羊中不显著(δMAP 1±10%,p > 0.5)。同样,低氧血症时肾血流量的变化(δRBF)在胎儿中显著(δRBF -51±24%,p < 0.001),但在新生羊中不显著(δRBF -9±38%,p > 0.1)。这些结果反映了低氧血症时肾血管阻力的变化(δRVR),在胎羊中显著(δRVR 169±168%,p < 0.01),但在新生羊中不显著(δRVR 51±180%,p > 0.2)。(摘要截断于250字)

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