Philipps A F, Rosenkrantz T S, Porte P J, Raye J R
Pediatr Res. 1985 Jul;19(7):659-66. doi: 10.1203/00006450-198507000-00005.
Hyperglycemia in fetal sheep has been shown to increase the fetal metabolic rate. Fetal venous glucose infusion was performed in eight late gestation, chronically catheterized fetal lambs to assess any changes in substrate uptake by the ovine uterus and conceptus. Fetal glucose infusion (11.9 +/- 0.6 mg glucose X kg-1 X min-1) caused a stable increase in fetal plasma glucose concentration approximately 3-fold above baseline. The fetal glucose entry rate increased from 6.6 +/- 0.7 to 9.3 +/- 0.6 mg X kg-1 X min-1 by day 3 of infusion (p less than 0.01) despite a net umbilical glucose excretion during the period of fetal hyperglycemia. Due to a concomitant increase in fetal oxygen consumption, no change in fetal glucose/O2 quotient was observed. A significant relationship was noted (p less than 0.02) between the fetal glucose entry rate and the rate of fetal oxygen consumption. Fetal glucose infusion caused a decrease in uterine glucose uptake as well. No changes were observed in calculated net placental glucose uptake although the relative fetal contribution increased from net placental exit to fetus to a placental uptake amounting to 20.8 +/- 5.8% of the total placental glucose uptake (p less than 0.01). Although no changes in fetal lactate concentration occurred, both maternal and fetal lactate entry rates increased, the magnitude of increase being significantly related to fetal glucose concentration. Both maternal and fetal insulin concentrations rose during the period of fetal hyperglycemia and were related to the respective increases of maternal or fetal substrate uptakes but not to fetal oxygen consumption.(ABSTRACT TRUNCATED AT 250 WORDS)
研究表明,胎羊高血糖会增加胎儿代谢率。对8只处于妊娠晚期、已长期植入导管的胎羊进行胎儿静脉输注葡萄糖,以评估绵羊子宫和孕体对底物摄取的任何变化。胎儿葡萄糖输注(11.9±0.6毫克葡萄糖×千克⁻¹×分钟⁻¹)使胎儿血浆葡萄糖浓度稳定升高至基线水平以上约3倍。尽管在胎儿高血糖期间脐部有葡萄糖净排泄,但到输注第3天时,胎儿葡萄糖进入率从6.6±0.7增加至9.3±0.6毫克×千克⁻¹×分钟⁻¹(p<0.01)。由于胎儿耗氧量同时增加,未观察到胎儿葡萄糖/氧气商的变化。观察到胎儿葡萄糖进入率与胎儿耗氧率之间存在显著关系(p<0.02)。胎儿葡萄糖输注也导致子宫对葡萄糖的摄取减少。尽管从胎盘向胎儿的净葡萄糖输出到胎盘摄取占胎盘葡萄糖总摄取量的20.8±5.8%,相对胎儿贡献增加,但计算得出的胎盘葡萄糖净摄取量未发生变化(p<0.01)。尽管胎儿乳酸浓度没有变化,但母体和胎儿的乳酸进入率均增加,增加幅度与胎儿葡萄糖浓度显著相关。在胎儿高血糖期间,母体和胎儿的胰岛素浓度均升高,且与母体或胎儿底物摄取的相应增加有关,但与胎儿耗氧量无关。(摘要截断于250字)