Castro L C, Arora C P, Roll K E, Sassoon D A, Hobel C J
Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Am J Obstet Gynecol. 1989 Sep;161(3):623-7. doi: 10.1016/0002-9378(89)90366-9.
Little is known about atrial natriuretic peptide metabolism or secretion in the human fetus. The purpose of this study was to determine if both the placenta and umbilical vessels are possible sites of atrial natriuretic peptide metabolism and to evaluate the effects that labor, route of delivery, prolonged pregnancy, preeclampsia, and fetal distress have on umbilical arterial atrial natriuretic peptide levels. We found that plasma atrial natriuretic peptide levels in the umbilical artery are significantly greater than those in the vein (p less than 0.001). Umbilical arterial and umbilical venous atrial natriuretic peptide levels were higher in plasma samples collected immediately at delivery when compared with those obtained 10 minutes later (p less than 0.001). Umbilical arterial atrial natriuretic peptide levels were elevated in pregnancies complicated by preeclampsia and fetal distress (p less than 0.01). Labor, route of delivery, and prolonged pregnancy had no effect on umbilical arterial atrial natriuretic peptide levels. We propose that both the placenta and umbilical vessels contain atrial natriuretic peptide receptors that are involved in the clearance or metabolism of atrial natriuretic peptide. The increased umbilical arterial atrial natriuretic peptide levels present in preeclampsia and fetal distress may reflect an attempt by the fetus to regulate blood flow.
关于人类胎儿的心房利钠肽代谢或分泌情况，人们所知甚少。本研究的目的是确定胎盘和脐血管是否为心房利钠肽代谢的可能部位，并评估分娩、分娩方式、过期妊娠、先兆子痫和胎儿窘迫对脐动脉心房利钠肽水平的影响。我们发现，脐动脉中的血浆心房利钠肽水平显著高于脐静脉中的水平（p<0.001）。与10分钟后采集的样本相比，分娩时立即采集的血浆样本中，脐动脉和脐静脉心房利钠肽水平更高（p<0.001）。先兆子痫和胎儿窘迫合并妊娠时，脐动脉心房利钠肽水平升高（p<0.01）。分娩、分娩方式和过期妊娠对脐动脉心房利钠肽水平无影响。我们认为，胎盘和脐血管均含有参与心房利钠肽清除或代谢的受体。先兆子痫和胎儿窘迫时脐动脉心房利钠肽水平升高，可能反映胎儿试图调节血流。
