Cohn H E, Piasecki G J, Cohen W R, Jackson B T
Department of Surgery, Brown University, Providence, R.I., USA.
Biol Neonate. 1997;72(2):125-32. doi: 10.1159/000244475.
This study was undertaken to determine whether or not metabolic acidemia per se stimulates catecholamine (CA) secretion from the adrenal medulla in fetal sheep. The potential confounding effect of low O2 content, occasioned by the right shift in the oxyhemoglobin dissociation curve with acidemia, was taken into account in experimental design. Hemodynamic values, blood gases, O2 content, lactate and glucose concentrations and adrenal CA secretion rates and plasma CA levels were studied in fetal sheep at baseline and during control (saline infusion) and acidemic (15 and 30% lactic acid infusion) periods. Experiments were conducted after recovery from preparative operations performed under general anesthesia. Arterial pH did not change with saline infusion. During 15 and 30% lactic acid infusions, pH fell to 7.23 and 7.09, respectively, as lactate concentrations increased 4.7 and 10 times. Arterial PCO2 increased from 50 to 58 torr during 30% lactic acid infusion. Fetal CA secretion and plasma concentrations did not change during saline, or 15 or 30% lactic acid infusions. Moreover, hemodynamic parameters did not indicate increased CA secretion. In conclusion, we found no evidence for stimulation of adrenal CA secretion by metabolic acidosis.
本研究旨在确定胎儿绵羊代谢性酸血症本身是否会刺激肾上腺髓质分泌儿茶酚胺(CA)。在实验设计中考虑了酸血症导致氧合血红蛋白解离曲线右移所引起的低氧含量的潜在混杂效应。研究了胎儿绵羊在基线以及对照期(输注生理盐水)和酸血症期(输注15%和30%乳酸)的血流动力学值、血气、氧含量、乳酸和葡萄糖浓度以及肾上腺CA分泌率和血浆CA水平。实验在全身麻醉下进行的准备手术后恢复后进行。输注生理盐水时动脉pH值未发生变化。在输注15%和30%乳酸期间,随着乳酸浓度分别增加4.7倍和10倍,pH值分别降至7.23和7.09。输注30%乳酸期间动脉PCO₂从50升至58托。在输注生理盐水、15%或30%乳酸期间,胎儿CA分泌和血浆浓度均未发生变化。此外,血流动力学参数并未表明CA分泌增加。总之,我们没有发现代谢性酸中毒刺激肾上腺CA分泌的证据。