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精氨酸加压素对胎羊的心血管作用及清除率

Cardiovascular effects and clearance of arginine vasopressin in the fetal lamb.

作者信息

Wiriyathian S, Porter J C, Naden R P, Rosenfeld C R

出版信息

Am J Physiol. 1983 Jul;245(1):E24-31. doi: 10.1152/ajpendo.1983.245.1.E24.

Abstract

Increased fetal secretion of arginine vasopressin (AVP) occurs in association with complicated pregnancies, asphyxia, and meconium-stained amniotic fluid (AF); yet, the role of AVP in fetal homeostasis remains unclear. Using chronically instrumented, near-term lamb fetuses (n = 8), we have ascertained the cardiovascular responses to doses of AVP ranging from 1.94 to 8.73 mU/min, the clearance of AVP from plasma, and the occurrence of meconium release into AF during AVP infusions. AVP administration resulted in a dose-related rise in arterial pressure; although heart rate fell, the decline was not dose-related and occurred before the pressor response. Clearance of plasma AVP was 60 +/- 8.7 ml X kg-1 X min-1, and the half-time in plasma was 2.8 min. AVP was not cleared across the fetal placenta nor by fetal-maternal transport. However, the AF concentration of AVP rose fourfold after the infusion of AVP was stopped. Meconium release into AF occurred in fetuses infused with AVP at rates greater than or equal to 7.76 mU/min. AVP has hemodynamic effects that mimic fetal responses to intrauterine "stress" and may be causally associated with the fetal release of meconium into AF. Furthermore, plasma AVP is cleared in part by the fetal kidney.

摘要

精氨酸加压素(AVP)在胎儿体内的分泌增加与复杂妊娠、窒息及羊水胎粪污染相关;然而,AVP在胎儿体内平衡中的作用仍不明确。我们使用长期植入监测装置的近足月羔羊胎儿(n = 8),确定了胎儿对剂量范围为1.94至8.73 mU/分钟的AVP的心血管反应、AVP从血浆中的清除率以及在输注AVP期间胎粪排入羊水的情况。给予AVP导致动脉血压呈剂量依赖性升高;虽然心率下降,但下降与剂量无关且发生在升压反应之前。血浆AVP的清除率为60±8.7 ml·kg⁻¹·min⁻¹,血浆半衰期为2.8分钟。AVP不会通过胎儿胎盘清除,也不会通过胎儿 - 母体转运清除。然而,停止输注AVP后,羊水中AVP浓度升高了四倍。在以大于或等于7.76 mU/分钟的速率输注AVP的胎儿中,出现了胎粪排入羊水的情况。AVP具有模拟胎儿对宫内“应激”反应的血流动力学效应,可能与胎儿胎粪排入羊水存在因果关系。此外,血浆AVP部分由胎儿肾脏清除。

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