Murphy William G
School of Medicine and Medical Science, University College Dublin, Ireland; Irish Blood Transfusion Service, Ireland.
Blood Rev. 2014 Mar;28(2):41-7. doi: 10.1016/j.blre.2013.12.003. Epub 2014 Jan 22.
Men and women have different mean haemoglobin levels in health in venous blood - women have mean levels approximately 12% lower than men. A similar sex-related difference in haemoglobin levels in adult animals is found in many species of mammals, birds and reptiles, indicating that it is an important physiological phenomenon. It is probably a direct effect of sex hormones, both oestrogen and androgens, on erythropoiesis. However, since there is no difference in erythropoietin levels between the sexes, this effect most likely takes place in the kidney, rather than in the bone marrow. Oestrogens dilate and androgens constrict the renal microvasculature: dilation and vasoconstriction in vessels below 300 μm in diameter respectively increase and decrease the haematocrit in blood in arterioles, capillaries and venules, altering the oxygen delivery per unit red cell mass, and providing a mechanism for varying the red cell mass without compensatory changes in erythropoiesis.
健康人群中,男性和女性静脉血的平均血红蛋白水平存在差异——女性的平均水平比男性低约12%。在许多哺乳动物、鸟类和爬行动物的成年动物中,也发现了类似的与性别相关的血红蛋白水平差异,这表明这是一种重要的生理现象。这可能是雌激素和雄激素这两种性激素对红细胞生成的直接作用。然而,由于两性之间促红细胞生成素水平没有差异,这种作用很可能发生在肾脏,而不是骨髓。雌激素使肾微血管扩张,雄激素使其收缩:直径小于300μm的血管发生扩张和收缩,分别会增加和降低小动脉、毛细血管和小静脉中血液的血细胞比容,改变单位红细胞量的氧气输送,并提供一种在不伴随红细胞生成代偿性变化的情况下改变红细胞量的机制。