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[生理性妊娠及合并缺铁性贫血妊娠时血红蛋白氧运输系统的状态]

[Status of the oxygen transport system of hemoglobin in physiological pregnancy and pregnancy complicated by iron deficiency anemia].

作者信息

Karpova I V, Dmitrieva M G, Novikov S A, Krekhnov B V

出版信息

Akush Ginekol (Mosk). 1992 Feb(2):13-7.

PMID:1476217
Abstract

The oxygen-binding properties of Hb molecule are unchanged in the third trimester of normal pregnancy and in pregnancy complicated by slight iron-deficiency anemia. Hb affinity to oxygen in whole blood is formed under the effect of the three main ligands H+, CO2, and 2,3-DPH. The development of hypocapnia in pregnant women results in elevation of pH values, reduction of pCO2, increase of intraerythrocytic 2,3-DPH concentration by 15-18%. Variously directed effects of H+, CO2, and 2,3-DPH on Hb affinity to O2 result in normal P50 values and therefore the Hb-O2 dissociation curve is not shifted to the right. Thus, in pregnant women with alkalosis 2,3-DPH effect on Hb affinity to oxygen completely eliminates H+ and CO2 effects but not compensates for Hb deficiency in the blood.

摘要

在正常妊娠晚期以及合并轻度缺铁性贫血的妊娠中,血红蛋白(Hb)分子的氧结合特性未发生改变。全血中Hb与氧的亲和力是在三种主要配体H⁺、CO₂和2,3 -二磷酸甘油酸(2,3 - DPG)的作用下形成的。孕妇低碳酸血症的发展导致pH值升高、pCO₂降低、红细胞内2,3 - DPG浓度增加15% - 18%。H⁺、CO₂和2,3 - DPG对Hb与O₂亲和力的不同作用导致正常的P50值,因此Hb - O₂解离曲线未向右偏移。所以,在患有碱中毒的孕妇中,2,3 - DPG对Hb与氧亲和力的作用完全消除了H⁺和CO₂的作用,但无法弥补血液中Hb的缺乏。

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