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窒息时胎羊心电图变化与β-肾上腺素能受体刺激及阻断的关系

ECG-changes in the fetal lamb during asphyxia in relation to beta-adrenoceptor stimulation and blockade.

作者信息

Hökegård K H, Karlsson K, Kjellmer I, Rosén K G

出版信息

Acta Physiol Scand. 1979 Feb;105(2):195-203. doi: 10.1111/j.1748-1716.1979.tb06331.x.

Abstract

Progressive changes in the S-T interval of the fetal electrocardiogram (FECG) were studied in 14 lamb fetuses, acutely exteriorized and subjected to graded hypoxia. The aims of the study were to investigate whether beta-adrenoceptor stimulation and hypoxia exerted additive or potentiating effects on the FECG and several cardiovascular parameters and whether the hypoxic changes of the FECG could be blocked by beta-adrenoceptor blocking agents. The FECG changes were studied in order to correlate them with cardiovascular function, as measured by heart rate, mean arterial pressure, end diastolic pressure, maximum dP/dt and combined cardiac output, estimated by the thermodilution method, as well as with blood gases, acid base status, blood lactate and glucose. Injections of small doses (0.02 to 0.4 microg kg-1 min-1) of isoprenaline induced the same pattern of changes in the FECG as we have previously recorded during hypoxia. By increasing the isoprenaline dose an increase in the duration of the FECG changes and amplitude of the T-wave changes was obtained. Propranolol was found to completely abolish the FECG changes induced by isoprenaline, as well as by mild hypoxia. During severe hypoxia the FECG changes could not be abolished by propranolol. Our previous findings indicated that the hypoxic changes could be regarded as a sign of myocardial glycolysis. Thus, the present finding that even small doses of isoprenaline given to the fetus, initiates the same pattern of FECG changes corroborate this hypothesis.

摘要

对14只急性暴露并接受分级低氧的绵羊胎儿的胎儿心电图(FECG)的S-T间期的进行性变化进行了研究。本研究的目的是调查β-肾上腺素能受体刺激和低氧对FECG和几个心血管参数是否产生相加或增强作用,以及FECG的低氧变化是否能被β-肾上腺素能受体阻滞剂阻断。研究FECG变化以便将其与心血管功能相关联,心血管功能通过心率、平均动脉压、舒张末期压力、最大dP/dt以及通过热稀释法估算的联合心输出量来衡量,同时也与血气、酸碱状态、血乳酸和血糖相关联。注射小剂量(0.02至0.4微克·千克⁻¹·分钟⁻¹)的异丙肾上腺素所诱发的FECG变化模式与我们之前在低氧期间记录到的相同。通过增加异丙肾上腺素剂量,可使FECG变化的持续时间和T波变化的幅度增加。发现普萘洛尔可完全消除由异丙肾上腺素以及轻度低氧所诱发的FECG变化。在严重低氧期间,普萘洛尔无法消除FECG变化。我们之前的研究结果表明,低氧变化可被视为心肌糖酵解的一个标志。因此,目前给胎儿注射即使小剂量的异丙肾上腺素也会引发相同模式的FECG变化这一发现证实了这一假说。

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