Leffler C W, Hessler J R, Green R S
Pediatr Res. 1984 Oct;18(10):938-42. doi: 10.1203/00006450-198410000-00006.
The purpose of the present study was to determine if pulmonary prostacyclin synthesis was stimulated by spontaneous onset of breathing by unanesthetized fetuses at birth. Cannulae were implanted and flow cuffs placed in fetal lambs and goats (0.93 term). Fetuses were delivered by cesarean section at 0.95 term and began breathing spontaneously. Prostacyclin in blood was determined by radioimmunoassay of its hydrolysis product, 6-ketoprostaglandin F1 alpha using methods that produced the same values in duplicate samples as did gas chromatography with electron capture detection. Fetal pulmonary prostacyclin production (left lung) [(left pulmonary venous concentration-pulmonary arterial concentration) X left pulmonary blood flow] was undetectable [-1.7 +/- 1.0 (SEM) ng PGI2 X kg-1 X min-1] and fetal pulmonary vascular resistance (left lung) high (5.1 +/- 0.9 mm Hg X kg X min X ml-1). Pulmonary prostacyclin production increased to 30.1 +/- 12.3 ngPGI2 X kg-1 X min-1 and pulmonary vascular resistance declined to 0.5 +/- 0.1 mm Hg X kg X min X ml-1 15 min after birth. Pulmonary vascular resistance remained low even though pulmonary prostacyclin production fell 2-5 h after birth. These results, coupled with earlier studies using indomethacin to inhibit prostaglandin synthesis, support the hypothesis that pulmonary prostacyclin synthesis participates in the decline of pulmonary vascular resistance that accompanies the onset of ventilation at birth, but may be less important in maintenance of low pulmonary vascular resistance once reduced pulmonary vascular tone has been established.
本研究的目的是确定出生时未麻醉胎儿自主呼吸的开始是否会刺激肺前列环素的合成。将套管植入胎羊和山羊(妊娠0.93期)并放置流量袖带。在妊娠0.95期通过剖宫产分娩胎儿,胎儿开始自主呼吸。使用在重复样本中产生与电子捕获检测气相色谱相同值的方法,通过对其水解产物6-酮前列腺素F1α进行放射免疫测定来确定血液中的前列环素。胎儿肺前列环素生成(左肺)[(左肺静脉浓度-肺动脉浓度)×左肺血流量]不可检测[-1.7±1.0(SEM)ng PGI2×kg-1×min-1],胎儿肺血管阻力(左肺)较高(5.1±0.9 mmHg×kg×min×ml-1)。出生后15分钟,肺前列环素生成增加至30.1±12.3 ng PGI2×kg-1×min-1,肺血管阻力降至0.5±0.1 mmHg×kg×min×ml-1。尽管出生后2-5小时肺前列环素生成下降,但肺血管阻力仍保持较低水平。这些结果,再加上早期使用吲哚美辛抑制前列腺素合成的研究,支持了这样一种假设,即肺前列环素合成参与了出生时通气开始时伴随的肺血管阻力下降,但一旦建立了降低的肺血管张力,在维持低肺血管阻力方面可能不太重要。