Pouta A M, Karinen J, Vuolteenaho O J, Laatikainen T J
Department of Obstetrics and Gynaecology, Oulu University Central Hospital, Finland.
Anaesthesia. 1996 Feb;51(2):128-32. doi: 10.1111/j.1365-2044.1996.tb07698.x.
The endogenous release of the vasoactive peptides atrial natriuretic peptide and endothelin-1 may modify maternal haemodynamic responses to a rapid intravenous volume load used to prevent hypotension at elective Caesarean delivery under spinal anaesthesia. Twenty-two healthy pregnant women were examined during elective Caesarean section at term pregnancy. They were randomly assigned to receive either 2000 ml of Ringer lactate solution (crystalloid group) or 500 ml of 6% hydroxyethyl starch + 1000 ml of Ringer lactate solution (colloid group). The mean (SEM) concentration of atrial natriuretic peptide in plasma increased from 10.9 (1.5) to 24.7 (5.1) pmol.l-1 during crystalloid infusion and from 10.3 (1.4) to 28.2 (5.6) pmol.l-1 during colloid infusion. A slight decrease in endothelin-1 levels was found during colloid infusion. A significant increase in the release of atrial natriuretic peptide in response to volume load may decrease vascular tone and initiate diuresis, thereby attenuating the effect of volume load on blood pressure during elective Caesarean delivery.
血管活性肽心房利钠肽和内皮素-1的内源性释放可能会改变产妇对快速静脉输液的血流动力学反应，这种快速静脉输液用于预防脊髓麻醉下择期剖宫产时的低血压。对22名足月妊娠的健康孕妇在择期剖宫产期间进行了检查。她们被随机分配接受2000毫升乳酸林格液（晶体液组）或500毫升6%羟乙基淀粉+1000毫升乳酸林格液（胶体液组）。晶体液输注期间，血浆中心房利钠肽的平均（SEM）浓度从10.9（1.5）皮摩尔/升增加到24.7（5.1）皮摩尔/升，胶体液输注期间从10.3（1.4）皮摩尔/升增加到28.2（5.6）皮摩尔/升。胶体液输注期间发现内皮素-1水平略有下降。对容量负荷反应时心房利钠肽释放的显著增加可能会降低血管张力并引发利尿，从而减弱择期剖宫产期间容量负荷对血压的影响。
