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[经脐带宫内抽取胎儿血液的血液流变学特征]

[Hemorrheological characteristics of fetal blood drawn in utero from the cord].

作者信息

Boulot P, Brun J F, Fons C, el Bouhmadi A, Hédon M N, Viala J L, Orsetti A

机构信息

Service de Gynécologie Obstétrique, Montpellier, France.

出版信息

Rev Fr Gynecol Obstet. 1991 Feb 25;86(2 Pt 2):154-7.

PMID:1767166
Abstract

Extensive studies of hemorheology of cord blood (drawn just after delivery) have evidentiated a peculiar rheological pattern: less filterable red cells, reduced erythrocyte aggregation, lowered plasma viscosity. This pattern has been suggested to be important for maintaining a sufficient O2 supply to fetal tissues, by avoiding hyperviscosity despite increased RBC rigidity. However, cord blood at birth is not exactly fetal blood and we are not yet aware of studies of fetal blood drawn in utero several weeks before delivery. For this reason, we investigated the rheological properties of fetal blood during intrauterine cord venepunctures in 27 pregnant women (25-30 week's gestation) who were explored for detection of fetal genetic or infectious diseases. Fetuses have lower plasma viscosity (p less than 0.001), lower RBC flexibility (measured by filterability on the Hémorhéomètre) (p less than 0.01) and higher hematocrit/viscosity ratio (p less than 0.01) than their mothers. While no temporal modification during the studied period (20-40 wk) was detected for hematocrit and plasma viscosity, RBC filterability (rigidity) seems to exhibit a 'U shaped curve' with a nadir between 25 and 30 weeks. This pilot study supports the hypothesis that the previously reported rheological properties of cord blood at birth reflect to some extent those of intra-uterine fetal blood.

摘要

对脐血(分娩后立即采集)血液流变学进行的广泛研究已证实其具有一种特殊的流变学模式:红细胞滤过性降低、红细胞聚集减少、血浆粘度降低。有人认为这种模式对于维持向胎儿组织充足供氧很重要,因为尽管红细胞刚性增加,但可避免血液高粘度。然而,出生时的脐血并不完全等同于胎儿血液,而且我们尚不了解在分娩前几周于子宫内采集的胎儿血液的研究情况。因此,我们对27名怀孕妇女(妊娠25 - 30周)在子宫内进行脐带穿刺时采集的胎儿血液的流变学特性进行了研究,这些妇女因检测胎儿遗传或传染病而接受检查。胎儿的血浆粘度低于母亲(p < 0.001),红细胞柔韧性较低(通过血液流变仪的滤过性测量)(p < 0.01),血细胞比容/粘度比值高于母亲(p < 0.01)。在所研究的时期(20 - 40周)内,未检测到血细胞比容和血浆粘度有随时间的变化,而红细胞滤过性(刚性)似乎呈现出一条“U形曲线”,最低点在25至30周之间。这项初步研究支持了这样一种假设,即先前报道的出生时脐血的流变学特性在一定程度上反映了子宫内胎儿血液的流变学特性。

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