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向母羊输注甘露醇高渗溶液后胎儿肾功能的变化。

Changes in fetal renal function in response to infusions of a hyperosmotic solution of mannitol to the ewe.

作者信息

Lumbers E R, Stevens A D

出版信息

J Physiol. 1983 Oct;343:439-46. doi: 10.1113/jphysiol.1983.sp014902.

Abstract

In six pregnant ewes a reduction in transplacental water transfer was produced by increasing maternal osmolality (by infusion of 180 g of mannitol in 500 ml of 0.15 M-sodium chloride) and the fetal renal responses to this reduction in water transfer were studied. These responses were compared with the renal responses of five other chronically catheterized fetal lambs whose mothers received I.V. infusions of 500 ml of 0.15 M-sodium chloride. Intravenous infusion of 500 ml of 0.15 M-sodium chloride to the ewe produced no changes in fetal plasma sodium, potassium or plasma renin activity and had no effect on fetal renal function. After I.V. infusion of mannitol to the ewe, fetal urinary flow rate fell from control levels of 0.69 +/- 0.12 ml/min to 0.32 +/- 0.04 ml/min (S.E. of mean, P less than 0.006). This fall in urinary flow rate was due to increased water reabsorption because there was no change in glomerular filtration rate and osmolar clearance. Fetal urinary sodium excretion increased from 16.2 +/- 2.0 mumol/min, to 34.2 +/- 6.9 mumol/min (S.E. of mean, P less than 0.04). This increase in fetal urinary sodium excretion was due to a fall in the fractional reabsorption of sodium which was related to this rise in fetal plasma sodium levels that occurred following infusion of mannitol to the ewe. The increases in fetal plasma sodium levels were also associated with reductions in fetal plasma renin activity.

摘要

在6只怀孕母羊中,通过增加母体渗透压(静脉输注500毫升0.15M氯化钠溶液中含180克甘露醇)使经胎盘的水转运减少,并研究了胎儿肾脏对这种水转运减少的反应。将这些反应与另外5只长期插管的胎儿羔羊的肾脏反应进行比较,这些羔羊的母亲静脉输注500毫升0.15M氯化钠溶液。向母羊静脉输注500毫升0.15M氯化钠溶液后,胎儿血浆钠、钾或血浆肾素活性无变化,对胎儿肾功能也无影响。向母羊静脉输注甘露醇后,胎儿尿流率从对照水平的0.69±0.12毫升/分钟降至0.32±0.04毫升/分钟(均值标准误,P<0.006)。尿流率的下降是由于水重吸收增加,因为肾小球滤过率和渗透清除率没有变化。胎儿尿钠排泄量从16.2±2.0微摩尔/分钟增加到34.2±6.9微摩尔/分钟(均值标准误,P<0.04)。胎儿尿钠排泄量的增加是由于钠的分数重吸收下降,这与向母羊输注甘露醇后胎儿血浆钠水平的升高有关。胎儿血浆钠水平的升高还与胎儿血浆肾素活性的降低有关。

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