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足月胎羊对急性缺氧的心血管反射反应的传入和传出成分。

Afferent and efferent components of the cardiovascular reflex responses to acute hypoxia in term fetal sheep.

作者信息

Giussani D A, Spencer J A, Moore P J, Bennet L, Hanson M A

机构信息

Department of Obstetrics and Gynaecology, University College and Middlesex School of Medicine, London.

出版信息

J Physiol. 1993 Feb;461:431-49. doi: 10.1113/jphysiol.1993.sp019521.

Abstract
  1. We studied the effects of acute isocapnic hypoxia on arterial and central venous pressures, carotid and femoral blood flows and heart rate in intact and carotid denervated fetal sheep between 118 and 125 days gestation, after pre-treatment with either saline, atropine or phentolamine. Electrocortical activity (ECoG) and the incidence of fetal breathing movements (FBM) were also compared between intact and carotid denervated fetuses. 2. There were no significant differences between intact and denervated fetuses in any variable measured during normoxia. Soon after the onset of hypoxia a marked bradycardia occurred in intact, but not in denervated fetuses. Femoral blood flow and femoral vascular resistance (perfusion pressure/femoral blood flow) increased in intact, but not in denervated fetuses. Carotid blood flow increased in both groups of fetuses during hypoxia, but carotid vascular resistance did not change. During hypoxia, the incidence of FBM and low-voltage ECoG was similarly reduced in both groups of fetuses. 3. Atropine produced a rise in fetal heart rate during the control period in intact but not in denervated fetuses. At the onset of hypoxia atropine prevented the initial bradycardia seen in intact fetuses. In denervated fetuses a further increase in heart rate occurred throughout the hypoxia. 4. All denervated fetuses treated with phentolamine died during the hypoxic challenge, but nine out of fourteen intact fetuses treated with phentolamine survived. 5. In intact fetuses which survived hypoxia after treatment with phentolamine, the increase in arterial blood pressure was smaller and the increase in femoral resistance did not occur. In these fetuses a rise in heart rate occurred in hypoxia. Carotid vascular resistance decreased during hypoxia after administration of phentolamine. 6. Our results indicate that the initial cardiovascular responses of the late gestation sheep fetus to hypoxia are reflex, and that the carotid chemoreceptors provide the afferent limb of this reflex. The bradycardia is mediated through a muscarinic pathway, as it is blocked by atropine. The femoral vasoconstriction is mediated through an alpha-adrenergic mechanism, mediated both neurally by a carotid chemoreflex and via catecholamines released directly from the adrenal medulla. Both these components are blocked by phentolamine. 7. The differences in survival between intact and denervated fetuses during hypoxia after phentolamine suggest that the carotid chemoreflex response to hypoxia involves mechanisms in addition to vagal efferents to the heart and alpha-adrenergic actions at peripheral blood vessels.(ABSTRACT TRUNCATED AT 400 WORDS)
摘要
  1. 我们研究了急性等碳酸血症性缺氧对妊娠118至125天的完整和颈动脉去神经支配的胎羊的动脉压和中心静脉压、颈动脉和股动脉血流量以及心率的影响,这些胎羊在预处理时分别使用了生理盐水、阿托品或酚妥拉明。还比较了完整和颈动脉去神经支配的胎儿的脑电活动(ECoG)和胎儿呼吸运动(FBM)的发生率。2. 在常氧期间测量的任何变量中,完整和去神经支配的胎儿之间均无显著差异。缺氧开始后不久,完整胎儿出现明显的心动过缓,而去神经支配的胎儿则未出现。完整胎儿的股动脉血流量和股血管阻力(灌注压/股动脉血流量)增加,而去神经支配的胎儿则未增加。两组胎儿在缺氧期间颈动脉血流量均增加,但颈动脉血管阻力未改变。在缺氧期间,两组胎儿的FBM发生率和低电压ECoG均同样降低。3. 阿托品在对照期使完整胎儿的心率升高,而去神经支配的胎儿则未升高。在缺氧开始时,阿托品可防止完整胎儿出现最初的心动过缓。在去神经支配的胎儿中,整个缺氧过程中心率进一步增加。4. 所有用酚妥拉明治疗的去神经支配的胎儿在缺氧挑战期间死亡,但14只接受酚妥拉明治疗的完整胎儿中有9只存活。5. 在酚妥拉明治疗后在缺氧中存活的完整胎儿中,动脉血压升高较小,且股动脉阻力未增加。在这些胎儿中,缺氧时心率升高。给予酚妥拉明后,缺氧期间颈动脉血管阻力降低。6. 我们的结果表明,妊娠晚期绵羊胎儿对缺氧的初始心血管反应是反射性的,并且颈动脉化学感受器提供了该反射的传入支。心动过缓是通过毒蕈碱途径介导的,因为它被阿托品阻断。股动脉血管收缩是通过α-肾上腺素能机制介导的,该机制通过颈动脉化学反射在神经上介导,并通过肾上腺髓质直接释放的儿茶酚胺介导。这两个成分均被酚妥拉明阻断。7. 酚妥拉明后缺氧期间完整和去神经支配的胎儿在存活方面的差异表明,颈动脉对缺氧的化学反射反应涉及除迷走神经对心脏的传出作用和外周血管的α-肾上腺素能作用之外的机制。(摘要截短至400字)

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