Segar J L, Merrill D C, Smith B A, Robillard J E
Department of Pediatrics, University of Iowa College of Medicine, Iowa City 52242.
Pediatr Res. 1994 Feb;35(2):250-4. doi: 10.1203/00006450-199402000-00026.
Significant fluctuation in heart rate (HR) and arterial pressure occur during fetal life. However, the mechanisms regulating this normal variability are not completely understood. To test the hypothesis that the normal variability in fetal HR and blood pressure are produced by intrinsic fluctuations in sympathetic outflow, we recorded HR, mean arterial blood pressure (MABP), and renal sympathetic nerve activity (RSNA) in conscious, chronically instrumented, near-term fetal sheep (n = 5; 132-137 d of gestation, term being 145 d) and correlated the relationships between RSNA and MABP, and RSNA and HR. RSNA, HR, and MABP were sampled at a frequency of 4 Hz and the values averaged by 5-min blocks over a 4-h period. Linear regression analysis demonstrated a positive correlation between RSNA and both HR and MABP in all five fetuses (p < 0.02). In a second group of fetuses (n = 5), ganglionic blockade with trimethaphan (150-250 mg/kg/min) significantly attenuated (p < 0.05) the coefficients of variation of HR (12.3 +/- 1.9% versus 1.7 +/- 0.6%) and MABP (5.8 +/- 0.6% versus 3.6 +/- 0.5%). These results demonstrate that, in the fetus, fluctuations in HR and MABP are mediated by changes in sympathetic outflow and suggest an important role for the autonomic nervous system in fetal cardiovascular regulation.
在胎儿期,心率(HR)和动脉血压会出现显著波动。然而,调节这种正常变异性的机制尚未完全明确。为了验证胎儿HR和血压的正常变异性是由交感神经输出的内在波动产生这一假设,我们在清醒、长期植入仪器的近足月胎羊(n = 5;妊娠132 - 137天,足月为145天)中记录了HR、平均动脉血压(MABP)和肾交感神经活动(RSNA),并关联了RSNA与MABP以及RSNA与HR之间的关系。RSNA、HR和MABP以4 Hz的频率采样,在4小时内按5分钟的时间段对数值进行平均。线性回归分析表明,在所有五只胎儿中,RSNA与HR和MABP均呈正相关(p < 0.02)。在第二组胎儿(n = 5)中,用三甲噻芬(150 - 250 mg/kg/min)进行神经节阻滞显著减弱了(p < 0.05)HR(12.3 +/- 1.9%对1.7 +/- 0.6%)和MABP(5.8 +/- 0.6%对3.6 +/- 0.5%)的变异系数。这些结果表明,在胎儿中,HR和MABP的波动是由交感神经输出的变化介导的,并提示自主神经系统在胎儿心血管调节中起重要作用。