Intravascular infusions of plasma into fetal sheep cause arterial and venous hypertension
Intravascular infusions of plasma into fetal sheep cause arterial and venous hypertension
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DOI：
10.1152/japplphysiol.01429.2004
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发表时间：
2005-09-01
影响因子：
3.3
通讯作者：
Anderson, DF
中科院分区：
文献类型：
--
作者：
Giraud, GD;Faber, JJ;Anderson, DF
胎儿体积控制是由胎儿和母体胎盘静水压力和胶体渗透压之间的平衡驱动的。肾脏对血容量调节的贡献很小，因为胎儿肾脏不能从胎儿室排出液体。我们假设胎儿血浆蛋白的增加会导致血浆胶体渗透压增加，从而导致胎儿动脉压和静脉压增加以及血管紧张素水平降低。将血浆或乳酸盐林格溶液注入五个双胞胎胎儿的每一个体内。 7天后，输注血浆的胎儿的胎儿蛋白质浓度为71.2+/-4.2g/l，而输注乳酸林格溶液的胎儿的胎儿蛋白质浓度为35.7+/-6.3g/l。输注乳酸林格溶液的胎儿的动脉压为68.0 +/- 3.6，而输注乳酸林格溶液的胎儿的动脉压为43.4 +/- 1.9 mmHg (P < 0.0003)，而输注血浆的胎儿的静脉压为4.8 +/- 0.3 mmHg，而输注血浆的胎儿的静脉压为3.3 +/- 0.4。注射乳酸林格液的胎儿中的毫米汞柱（P < 0.036）。在血浆蛋白输注第 0、7 和 14 天对 6 个胎儿进行了研究。 14天后胎儿蛋白浓度从31.1+/-1.5增加到84.8+/-3.8g/l(P<0.01)，动脉压从43.1+/-1.8增加到69.1+/-4.1mmHg(P<0.01)。静脉压从 3.0 +/- 0.4 增加至 6.2 +/- 1.3 mmHg (P < 0.05)。胎心率没有变化。 14 天后，血管紧张素 H 浓度从 24.6 +/- 5.6 下降至 2.9 +/- 1.3 pg/l (P < 0.01)。胎儿血浆输注会导致胎儿动脉和静脉高血压，而这种高血压无法通过降低血管紧张素 II 水平来纠正。
Fetal volume control is driven by an equilibrium between fetal and maternal hydrostatic and oncotic pressures in the placenta. Renal contributions to blood volume regulation are minor because the fetal kidneys cannot excrete fluid from the fetal compartment. We hypothesized that an increase in fetal plasma protein would lead to an increase in plasma oncotic pressure, resulting in an increase in fetal arterial and venous pressures and decreased angiotensin levels. Plasma or lactated Ringer solution was infused into each of five, twin fetuses. After 7 days, fetal protein concentration was 71.2 +/- 4.2 g/l in the plasma-infused fetuses compared with 35.7 +/- 6.3 g/l in the lactated Ringer-solution-infused fetuses. Arterial pressure was 68.0 +/- 3.6 compared with 43.4 +/- 1.9 mmHg in the lactated Ringer solution-infused fetuses (P < 0.0003), whereas venous, pressure was 4.8 +/- 0.3 mmHg in the plasma-infused fetuses compared with 3.3 +/- 0.4. mmHg in the lactated Ringer solution-infused fetuses (P < 0.036). Six fetuses were studied on days 0, 7, and 14 of plasma protein infusion. Fetal protein concentration increased from 31.1 +/- 1.5 to 84.8 +/- 3.8 g/l after 14 days,(P < 0.01), and arterial pressure increased from 43.1 +/- 1.8 to 69.1 +/- 4.1 mmHg (P < 0.01). Venous pressure increased from 3.0 +/- 0.4 to 6.2 +/- 1.3 mmHg (P < 0.05). Fetal heart rate did not change. Angiotensin H concentration decreased, from 24.6 +/- 5.6 to 2.9 +/- 1.3 pg/l, after 14 days (P < 0.01). Fetal plasma infusions resulted in fetal arterial and venous hypertensions that could not be corrected by reductions in angiotensin II levels.