Malek A, Miller R K, Mattison D R, Ceckler T, Panigel M, di Sant'Agnese P A, Jessee L N
Department of Obstetrics and Gynecology, University of Rochester Medical Center, New York 14642, USA.
J Appl Physiol (1985). 1995 May;78(5):1778-86. doi: 10.1152/jappl.1995.78.5.1778.
ATP was examined in dually perfused term human placentas by using 31P-nuclear magnetic resonance (NMR) spectroscopy. 31P-NMR spectra were acquired every 30 min starting approximately 30 min after establishing fetal and maternal perfusions, and maternal perfusate samples were obtained to monitor glucose utilization, lactate production, and human chorionic gonadotropin (hCG) and human placental lactogen (hPL) release. In continuous-perfusion experiments, placentas were perfused as long as 10 h. ATP increased and Pi fell after initiation of perfusion. Fetal volume loss was < 2 ml/h, and constant production of hCG, hPL, and lactate as well as constant utilization of glucose were observed. In additional experiments, ischemia was produced by halting maternal and fetal perfusion pumps after a 2-h control period. After 2, 3, or 4 h of ischemia, ATP decreased 46 +/- 17, 51 +/- 5, and 85% of control, respectively. When perfusion was reinitiated, ATP increased and was maintained for the duration of the experiment (an additional 2 h). Recovery of ATP after reperfusion was not paralleled by recovery in glucose utilization, lactate production, or hPL and hCG release. However, during the reperfusion period, fetal pressure was < 70 mmHg and fetal volume loss was < 2 ml/h. These investigations suggest that the dually perfused human placental lobule can maintain ATP for > or = 10 h. Although the perfused human placenta recovers ATP and maintains fetal perfusion volume after ischemia lasting up to 4 h, utilization of glucose, production of lactate, and production and release of hCG and hPL are impaired.
采用31P-核磁共振（NMR）波谱法对足月双灌注人胎盘进行了ATP检测。在建立胎儿和母体灌注后约30分钟开始，每隔30分钟采集一次31P-NMR波谱，并采集母体灌注液样本以监测葡萄糖利用、乳酸生成以及人绒毛膜促性腺激素（hCG）和人胎盘催乳素（hPL）的释放。在连续灌注实验中，胎盘灌注长达10小时。灌注开始后ATP增加，无机磷酸盐（Pi）下降。胎儿体积损失<2 ml/h，观察到hCG、hPL和乳酸持续生成以及葡萄糖持续利用。在另外的实验中，在2小时的对照期后停止母体和胎儿灌注泵，造成缺血。缺血2、3或4小时后，ATP分别下降至对照值的46±17%、51±5%和85%。当重新开始灌注时，ATP增加并在实验持续时间内（额外2小时）维持。再灌注后ATP的恢复与葡萄糖利用、乳酸生成或hPL和hCG释放的恢复并不平行。然而，在再灌注期间，胎儿压力<70 mmHg，胎儿体积损失<2 ml/h。这些研究表明，双灌注人胎盘小叶可维持ATP达≥10小时。尽管灌注人胎盘在长达4小时的缺血后可恢复ATP并维持胎儿灌注量，但葡萄糖利用、乳酸生成以及hCG和hPL的生成与释放均受损。
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