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产科低血容量休克时肾和子宫血流调节的实验研究(作者译)

[Experimental study of renal and uterine blood flow regulation in obstetric hypovolemic shock (author's transl)].

作者信息

Sanda Y

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1982 Jul;34(7):905-14.

PMID:7108308
Abstract

Dynamics of the renal and uterine circulation in response to the hypovolemic shock were studied in anesthetized pregnant and nonpregnant dogs. The renal arterial blood flow (RABF), uterine arterial blood flow (UABF) and mean arterial blood pressure (MAP) were electronically integrated and recorded during the removal of 500 ml blood at the rate of 3 ml per minute. In nonpregnant bitches, there was a pronounced decrease in RABF after the 300 ml blood removal, and it became 85.2 per cent from the control level at the time of 500 ml blood removal (MAP 34.6 mmHg). In pregnant bitches however, the rapid decrease in UABF was invoked after the 200 ml blood removal, reaching 85.3 per cent decrease from the control level at the time of 500 ml blood removal (MAP 59.8 mmHg), while the decrease in RBF was attenuated in comparison with the nonpregnant animals. The decrease in UBF in pregnant animal was associated with remarkable increase in uterine vascular resistance. This implies that the hypovolemic shock generates a lending and borrowing phenomenon between the renal and uterine circulation in pregnant subject. As evidenced by the enhanced vasoconstrive responses of uterine vascular bed to injected norepinephrine (50 microgram) during the hypovolemic shock in pregnant animals, the activation on alpha receptors in the uterine vascular bed is the main cause of the phenomenon.

摘要

在麻醉的妊娠和非妊娠犬中研究了肾和子宫循环对低血容量性休克的反应动力学。在以每分钟3毫升的速度抽取500毫升血液的过程中,对肾动脉血流量(RABF)、子宫动脉血流量(UABF)和平均动脉血压(MAP)进行电子积分并记录。在非妊娠母犬中,抽取300毫升血液后RABF明显下降,在抽取500毫升血液时(MAP为34.6 mmHg)降至对照水平的85.2%。然而,在妊娠母犬中,抽取200毫升血液后UABF迅速下降,在抽取500毫升血液时(MAP为59.8 mmHg)降至对照水平的85.3%,而与非妊娠动物相比,RBF的下降有所减轻。妊娠动物中UBF的下降与子宫血管阻力的显著增加有关。这意味着低血容量性休克在妊娠受试者的肾和子宫循环之间产生了一种借贷现象。妊娠动物在低血容量性休克期间子宫血管床对注射去甲肾上腺素(50微克)的血管收缩反应增强,这证明子宫血管床中α受体的激活是该现象的主要原因。

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