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β-肾上腺素能阻滞剂对胎羊低氧血症期间血流分布的影响。

Effects of beta-adrenergic blockade on blood flow distribution during hypoxaemia in fetal sheep.

作者信息

Court D J, Parer J T, Block B S, Llanos A J

出版信息

J Dev Physiol. 1984 Aug;6(4):349-58.

PMID:6481111
Abstract

Hypoxaemia in fetal sheep causes a decrease in vascular resistance of the heart, brain and adrenal gland which results in increased blood flow to these organs. Placental blood flow is maintained. To investigate whether increased beta-adrenergic activity during hypoxaemia is involved in these changes, the effects of propranolol on organ blood flows (using the microsphere method) and other cardiovascular variables were studied during fetal hypoxaemia (50% reduction of fetal haemoglobin saturation) in 5 chronically catheterized fetal sheep at 126 to 130 days of gestation. Beta-blockade during hypoxaemia caused a fetal bradycardia and a 30% drop in cardiac output. Placental and myocardial blood flows fell by 39% and 37% respectively. Total peripheral resistance increased by 35% mainly due to increased fetal placental vascular resistance. Heart and lung vascular resistances increased following propranolol. In 3 similarly catheterized animals, propranolol administered in the absence of hypoxaemia led to a 9% drop in cardiac output and placental blood flow but no redistribution of blood flow to fetal organs. It is concluded that the increased beta-adrenergic activity associated with fetal hypoxaemia limits the negative chronotropic effects of concomitantly increased vagal activity, maintains placental blood flow through its inotropic and chronotropic activity as well as by maintenance of placental vasodilatation and may be one of several factors which increase myocardial blood flow during hypoxaemia.

摘要

胎羊低氧血症会导致心脏、大脑和肾上腺的血管阻力降低,从而使这些器官的血流量增加。胎盘血流量得以维持。为了研究低氧血症期间β-肾上腺素能活性增加是否与这些变化有关,在妊娠126至130天的5只长期插管的胎羊中,研究了普萘洛尔对低氧血症(胎儿血红蛋白饱和度降低50%)期间器官血流量(使用微球法)和其他心血管变量的影响。低氧血症期间的β受体阻滞导致胎儿心动过缓和心输出量下降30%。胎盘和心肌血流量分别下降39%和37%。总外周阻力增加35%,主要是由于胎儿胎盘血管阻力增加。普萘洛尔给药后心脏和肺血管阻力增加。在3只同样插管的动物中,在无低氧血症的情况下给予普萘洛尔导致心输出量和胎盘血流量下降9%,但没有出现血流重新分配至胎儿器官的情况。得出的结论是,与胎儿低氧血症相关的β-肾上腺素能活性增加限制了伴随的迷走神经活性增加的负性变时作用,通过其正性肌力和变时活性以及维持胎盘血管舒张来维持胎盘血流量,并且可能是低氧血症期间增加心肌血流量的几个因素之一。

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