Hooper S B
Department of Physiology, Monash University, Clayton, Victoria, 3168, Australia.
Exp Physiol. 1998 Nov;83(6):833-42. doi: 10.1113/expphysiol.1998.sp004163.
The mechanism by which pulmonary blood flow increases and pulmonary vascular resistance decreases after birth is not fully understood. The aim of this study was to simulate the decrease in lung volume caused by the onset of air-breathing at birth and determine whether it can duplicate the changes in pulmonary blood flow and vascular resistance that occur at this time. In chronically catheterized fetal sheep near term (145 days of gestation), fetal pulmonary arterial blood flow was measured, using coloured microspheres, before and after fetal lung liquid volumes were reduced from 52.2 +/- 2.7 to 21.2 +/- 1.6 ml kg-1. During the 30 min period following the reduction in lung liquid volume, the pulmonary-to-systemic arterial pressure difference decreased from 6.8 +/- 1.2 mmHg (pulmonary > systemic) to 1.6 +/- 0.5 mmHg. Reducing the volume of fetal lung liquid increased pulmonary blood flow from 59.1 +/- 10.5 to 204.2 +/- 40.4 ml min-1 (100 g tissue)-1 and reduced pulmonary vascular resistance from 0.53 +/- 0.20 to 0.14 +/- 0.04 mmHg min ml-1 (100 g tissue)-1. We conclude that a reduction in fetal lung liquid volume, which simulates the reduction in lung volume that occurs at birth, causes a 3- to 4-fold increase in pulmonary blood flow and a reduction in pulmonary vascular resistance of a similar magnitude. Thus, the reduction in lung volume associated with the lung changing from a liquid- to an air-filled organ, may partly account for the increase in pulmonary blood flow and decrease in pulmonary vascular resistance at birth.
出生后肺血流量增加和肺血管阻力降低的机制尚未完全明确。本研究旨在模拟出生时开始呼吸导致的肺容积减小,并确定其是否能重现此时肺血流量和血管阻力的变化。在接近足月(妊娠145天)的慢性插管胎羊中,在胎肺液体量从52.2±2.7ml/kg降至21.2±1.6ml/kg之前和之后,使用彩色微球测量胎儿肺动脉血流量。在肺液体量减少后的30分钟内,肺与体循环动脉压差从6.8±1.2mmHg(肺>体循环)降至1.6±0.5mmHg。减少胎肺液体量使肺血流量从59.1±10.5增加至204.2±40.4ml·min-1(100g组织)-1,并使肺血管阻力从0.53±0.20降至0.14±0.04mmHg·min·ml-1(100g组织)-1。我们得出结论,模拟出生时发生的肺容积减小的胎肺液体量减少,会导致肺血流量增加3至4倍,并使肺血管阻力降低类似幅度。因此,与肺从充满液体变为充满空气的器官相关的肺容积减小,可能部分解释了出生时肺血流量增加和肺血管阻力降低的现象。