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控制胎羊低氧血症期间醛固酮分泌的因素。

Factors controlling aldosterone secretion during hypoxemia in fetal lambs.

作者信息

Robillard J E, Ayres N A, Gomez R A, Nakamura K T, Smith F G

出版信息

Pediatr Res. 1984 Jul;18(7):607-11. doi: 10.1203/00006450-198407000-00008.

Abstract

Factors modulating the fetal aldosterone response to hypoxemia were studied in three groups of chronically catheterized fetal lambs between 131 and 143 days of gestation (term, 145 days). One group (control group) received an infusion of 5% dextrose in water; the second group (captopril-treated group) was given captopril, an inhibitor of angiotensin-converting enzyme; the third group (captopril plus dexamethasone-treated group) received dexamethasone in addition to captopril. In all groups of fetuses, hypoxemia was associated with a significant increase in plasma K+ concentration (+0.7 +/- 0.1 meq/liter). In control fetuses, changes in plasma aldosterone concentration during hypoxemia correlated closely with changes in plasma K+ concentration r = 0.79; P less than 0.001) and with changes in plasma angiotensin II concentration (r = 0.77; P less than 0.001). In the captopril-treated fetuses, the rise in plasma aldosterone concentration during hypoxemia correlated closely with plasma K+ (r = 0.79; P less than 0.001) but not with plasma angiotensin II values (r = 0.17). No significant correlation was found between percent changes in maternal aldosterone and percent changes in fetal aldosterone during hypoxemia and following recovery (r = 0.36; P greater than 0.1) in captopril-treated fetuses. Administration of dexamethasone to fetuses receiving captopril completely inhibited the rise in plasma aldosterone associated with hypoxemia. Taken together, the present results suggest that the rise in plasma aldosterone during hypoxemia is not related to the level of activity of the renin-angiotensin system but depends probably on the increased secretion of adrenocorticotrophin by the fetus.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在三组妊娠131至143天(足月为145天)的慢性插管胎羊中研究了调节胎儿醛固酮对低氧血症反应的因素。一组(对照组)输注5%葡萄糖溶液;第二组(卡托普利治疗组)给予卡托普利,一种血管紧张素转换酶抑制剂;第三组(卡托普利加地塞米松治疗组)除卡托普利外还给予地塞米松。在所有胎儿组中,低氧血症与血浆钾浓度显著升高(+0.7±0.1毫当量/升)相关。在对照胎儿中,低氧血症期间血浆醛固酮浓度的变化与血浆钾浓度的变化密切相关(r = 0.79;P<0.001),也与血浆血管紧张素II浓度的变化相关(r = 0.77;P<0.001)。在卡托普利治疗的胎儿中,低氧血症期间血浆醛固酮浓度的升高与血浆钾密切相关(r = 0.79;P<0.001),但与血浆血管紧张素II值无关(r = 0.17)。在卡托普利治疗的胎儿中,低氧血症期间及恢复后母体醛固酮百分比变化与胎儿醛固酮百分比变化之间未发现显著相关性(r = 0.36;P>0.1)。对接受卡托普利的胎儿给予地塞米松完全抑制了与低氧血症相关的血浆醛固酮升高。综上所述,目前的结果表明,低氧血症期间血浆醛固酮的升高与肾素-血管紧张素系统的活性水平无关,可能取决于胎儿促肾上腺皮质激素分泌的增加。(摘要截短于250字)

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