Mak K K, Gude N M, Walters W A, Boura A L
Br J Obstet Gynaecol. 1984 Feb;91(2):99-106. doi: 10.1111/j.1471-0528.1984.tb05890.x.
Studies have been made of the effects of autacoids on vascular tone of the human perfused fetal umbilical vein and placental lobule. The thromboxane A2 (TxA2)-mimetic substance U46619, 5-hydroxytryptamine and bradykinin were powerful constrictors of the vein. Prostaglandins E2 (PGE2), F2 alpha (PGF2 alpha), adrenaline, noradrenaline, histamine and angiotensin II were much less potent. Venoconstriction caused by U46619, bradykinin and 5-hydroxytryptamine was reduced during inhibition of phospholipase A2 with mepacrine. Responses to U46619 were also reduced after inhibition of cyclo-oxygenase with indomethacin whereas those to bradykinin and 5-hydroxytryptamine were potentiated. In the placenta U46619 was the most potent vasoconstrictor, bradykinin, 5-hydroxytryptamine, angiotensin II, PGE2 and PGF2 alpha being 10-100 times less active. Responses to U46619 were reduced by either mepacrine or indomethacin. Arachidonic acid caused umbilical venoconstriction but vasodilatation in the placenta. Both effects were reduced by indomethacin. Prostacyclin (PGI2) caused vasodilatation in both preparations. It is suggested that TxA2 in the placenta and TxA2, 5-hydroxytryptamine and bradykinin in the umbilical vein could contribute to control of vascular smooth muscle tone. Their vasoconstrictor effects are partly indirect and affected by the concomitant local release of eicosanoids. The results add support to previous conclusions that these autacoids may normally have important influences on blood flow in the fetal extra-corporeal circulation. Agents inhibiting their synthesis, eg non-steroidal anti-inflammatory agents, should only be prescribed during pregnancy with these facts in mind.
已经对自分泌物质对人体灌注胎儿脐静脉和胎盘小叶血管张力的影响进行了研究。血栓素A2(TxA2)模拟物U46619、5-羟色胺和缓激肽是该静脉的强力收缩剂。前列腺素E2(PGE2)、F2α(PGF2α)、肾上腺素、去甲肾上腺素、组胺和血管紧张素II的效力则低得多。在用米帕林抑制磷脂酶A2期间,U46619、缓激肽和5-羟色胺引起的静脉收缩减弱。在用吲哚美辛抑制环氧化酶后,对U46619的反应也减弱,而对缓激肽和5-羟色胺的反应则增强。在胎盘中,U46619是最有效的血管收缩剂,缓激肽、5-羟色胺、血管紧张素II、PGE2和PGF2α的活性要低10至100倍。米帕林或吲哚美辛均可降低对U46619的反应。花生四烯酸可引起脐静脉收缩,但在胎盘中则引起血管舒张。两种作用均被吲哚美辛减弱。前列环素(PGI2)在两种制剂中均引起血管舒张。提示胎盘中的TxA2以及脐静脉中的TxA2、5-羟色胺和缓激肽可能有助于控制血管平滑肌张力。它们的血管收缩作用部分是间接的,并受到同时局部释放的类二十烷酸的影响。这些结果支持了先前的结论,即这些自分泌物质通常可能对胎儿体外循环中的血流有重要影响。在孕期开具抑制其合成的药物(如非甾体类抗炎药)时应牢记这些事实。