Brown E G, Mendoza G J, Chervenak F A, Karmel B Z, Krouskop R W, LeBlanc M H, Winslow R M, Moll G W
Department of Pediatrics, Mt. Sinai Medical Center, New York, New York.
Am J Obstet Gynecol. 1990 Jan;162(1):223-9. doi: 10.1016/0002-9378(90)90855-2.
The relation of fetal growth and maternal oxygen transport as assessed by red blood cell 2,3-diphosphoglycerate, hemoglobin oxygen affinity, hemoglobin, pH, and PCO2 was evaluated in 21 pregnant women. The study was performed in the third trimester and each subject evaluated had sonographic evidence of fetal growth retardation without other obvious abnormalities. Decreased maternal 2,3-diphosphoglycerate/hemoglobin molar ratio and hemoglobin oxygen affinity were related linearly to the birth weight normalized for the expected sea level values of gestational age expressed as a birth weight (gestational age-normalized) Z score. The correlation coefficients and p values were r = 0.71, p less than 0.001 and r = 0.67, p less than 0.001, respectively. The ponderal index-normalized Z score correlated with the 2,3-diphosphoglycerate/hemoglobin molar ratio (r = 0.46, p less than 0.04), but the relation was not as strong as the birth weight-normalized Z score. The crown-heel length/head circumference ratio did not correlate with the 2,3-diphosphoglycerate/hemoglobin molar ratio (r = 0.29, NS). The birth weight (gestational age)-normalized Z score did not correlate with hemoglobin, PCO2, or pH. In the regulation of hemoglobin oxygen affinity, calculations indicated that the 2,3-diphosphoglycerate/hemoglobin molar ratio played a highly significant role (p less than 0.001), pH was minimally significant (p less than 0.025), but PCO2 had little or no significant effects in this study. It appears that fetal growth is related to the maternal red blood cell oxygen transport parameters 2,3-diphosphoglycerate/hemoglobin molar ratio and hemoglobin oxygen affinity. Moreover, the 2,3-diphosphoglycerate/hemoglobin molar ratio is the principal regulator of hemoglobin oxygen affinity.
通过红细胞2,3 - 二磷酸甘油酸、血红蛋白氧亲和力、血红蛋白、pH值和二氧化碳分压评估胎儿生长与母体氧运输之间的关系，对21名孕妇进行了研究。该研究在孕晚期进行，每个评估对象均有胎儿生长受限的超声证据且无其他明显异常。母体2,3 - 二磷酸甘油酸/血红蛋白摩尔比和血红蛋白氧亲和力降低与根据孕周预期海平面值标准化的出生体重呈线性相关，该出生体重表示为出生体重（孕周标准化）Z评分。相关系数和p值分别为r = 0.71，p < 0.001和r = 0.67，p < 0.001。体重指数标准化Z评分与2,3 - 二磷酸甘油酸/血红蛋白摩尔比相关（r = 0.46，p < 0.04），但这种关系不如出生体重标准化Z评分那么强。顶臀长/头围比与2,3 - 二磷酸甘油酸/血红蛋白摩尔比不相关（r = 0.29，无统计学意义）。出生体重（孕周）标准化Z评分与血红蛋白、二氧化碳分压或pH值不相关。在血红蛋白氧亲和力的调节中，计算表明2,3 - 二磷酸甘油酸/血红蛋白摩尔比起非常显著的作用（p < 0.001），pH值作用极小（p < 0.025），但在本研究中二氧化碳分压几乎没有显著影响。看来胎儿生长与母体红细胞氧运输参数2,3 - 二磷酸甘油酸/血红蛋白摩尔比和血红蛋白氧亲和力有关。此外，2,3 - 二磷酸甘油酸/血红蛋白摩尔比是血红蛋白氧亲和力的主要调节因子。
