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子宫内胎羊低氧血症时前列腺素对肾循环的调控

Prostaglandin control of the renal circulation in response to hypoxemia in the fetal lamb in utero.

作者信息

Millard R W, Baig H, Vatner S F

出版信息

Circ Res. 1979 Aug;45(2):172-9. doi: 10.1161/01.res.45.2.172.

Abstract

We studied the effects of 10-minute periods of hypoxemia in unanesthetized fetal lambs in utero instrumented for measurements of arterial pressure and renal and iliac blood flows. Fetal hypoxemia, induced by delivering a hypoxic gas mixture to the ewe, was characterized by a reduction in fetal PaO2 from 20.1 +/- 1.4 to 8.8 +/- 1.0 mm Hg (mean +/- SE). The fetus responded with bradycardia and persistent vasoconstriction in the iliac bed throughout the 10-minute period. In contrast, renal resistance rose significantly only at the end of the hypoxemic period. After 5-7 minutes of hypoxemia, when iliac flow had fallen by 40 +/- 4% and iliac resistance had risen by 86 +/- 13%, renal flow and resistance were not changed significantly from control; in fact, we found that renal flow rose substantially at this time in several fetal lambs. After blockade of prostaglandin synthesis with either indomethacin or meclofenamate, renal flow fell after 5-7 minutes of hypoxemia by 36 +/- 5%. The reduction in renal flow and increases in renal resistance were significantly greater than was observed prior to blockade of prostaglandin synthesis. Thus, fetal hypoxemia elicits bradycardia and intense peripheral vasoconstriction reflected by the changes in the iliac bed, with relative sparing of the reanl bed. The relative protection of the renal bed during fetal hypoxemia appears to be related to a mechanism involving prostaglandins, since after blockade of prostaglandin synthesis, hypoxemia results in intense renal vasoconstriction.

摘要

我们研究了在子宫内未麻醉的胎羊中,持续10分钟低氧血症对动脉压、肾血流和髂血流测量的影响。通过向母羊输送低氧气体混合物诱导胎儿低氧血症,其特征是胎儿动脉血氧分压(PaO2)从20.1±1.4毫米汞柱降至8.8±1.0毫米汞柱(平均值±标准误)。在整个10分钟期间,胎儿出现心动过缓,髂血管床持续血管收缩。相比之下,肾血管阻力仅在低氧血症期结束时显著升高。低氧血症5 - 7分钟后,当髂血流下降40±4%且髂血管阻力升高86±13%时,肾血流和阻力与对照组相比无显著变化;事实上,我们发现此时几只胎羊的肾血流大幅上升。在用吲哚美辛或甲氯芬那酸阻断前列腺素合成后,低氧血症5 - 7分钟后肾血流下降36±5%。肾血流的减少和肾血管阻力的增加显著大于前列腺素合成阻断前观察到的情况。因此,胎儿低氧血症引发心动过缓和强烈的外周血管收缩,这通过髂血管床的变化反映出来,而肾血管床相对未受影响。胎儿低氧血症期间肾血管床的相对保护似乎与一种涉及前列腺素的机制有关,因为在阻断前列腺素合成后,低氧血症会导致强烈的肾血管收缩。

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