Merlet-Benichou C
Poumon Coeur. 1975;31(4):197-203.
In the mammalian foetus, the blood oxygen tension is low (PaO2 congruent to 25 Torr). The factors limiting the oxygen transfer from maternal into foetal blood are mainly the vascular arrangement and the distribution of blood flow within the placenta. The oxygen diffusion across the placenta in facilitated by a higher oxygen affinity in foetal than in maternal blood. During placental gas exchange the Bohr Effect acts in both the maternal and foetal blood to shift their oxyhaemoglobin dissociation curve so that the mean oxygen pressure gradient across the placental membrane is increased. The two main characteristics of foetal blood, a high oxygen capacity and a high oxygen affinity are well adapted to hypoxaemia since, together with a high cardiac output, they ensure an adequate oxygen supply to the foetal tissues. These characteristics of foetal blood disappear during the postnatal period in all the species thus far investigated. The change in the blood oxygen affinity which occurs in the foetus and the newborn have been attributed in some species to the presence of a foetal haemoglobin (HbF) which differs from the adult haemoglobin (HbA) either by an intrinsically higher oxygen affinity, independant of any intracellular cofactor, or by an impaired reactivity towards cofactors which alter haemoglobin oxygen affinity by directly interacting with the haemoglobin molecule (2,3 DPG, CO2). In those species in which HbF has not been shown to be structurally and functionally different from HbA, change in 2,3 DPG concentration can explain change in oxygen affinity.
在哺乳动物胎儿中,血氧张力较低(动脉血氧分压约为25托)。限制氧气从母体血液向胎儿血液转移的因素主要是胎盘内的血管排列和血流分布。胎儿血液比母体血液具有更高的氧亲和力,这有利于氧气在胎盘内的扩散。在胎盘气体交换过程中,波尔效应在母体和胎儿血液中均起作用,使它们的氧合血红蛋白解离曲线发生移动,从而增加了胎盘膜两侧的平均氧分压梯度。胎儿血液的两个主要特征,即高氧容量和高氧亲和力,非常适合低氧血症,因为它们与高心输出量一起,确保了向胎儿组织提供充足的氧气供应。在迄今为止所研究的所有物种中,胎儿血液的这些特征在出生后都会消失。在某些物种中,胎儿和新生儿血液氧亲和力的变化归因于胎儿血红蛋白(HbF)的存在,它与成人血红蛋白(HbA)的不同之处在于,要么具有本质上更高的氧亲和力(独立于任何细胞内辅因子),要么对通过与血红蛋白分子直接相互作用而改变血红蛋白氧亲和力的辅因子(2,3-二磷酸甘油酸、二氧化碳)反应性受损。在那些未显示HbF在结构和功能上与HbA不同的物种中,2,3-二磷酸甘油酸浓度的变化可以解释氧亲和力的变化。