Mizutani S
Department of Obstetrics and Gynecology, Nagoya University School of Medicine.
Nihon Sanka Fujinka Gakkai Zasshi. 1994 Aug;46(8):729-34.
Both fetal and maternal blood pressure is regulated mainly by the humoral factor, vasoactive peptides such as angiotensin II and vasopressin, but not by autoregulation and the autonomic nervous system. It is known that the normal musculoelastic tissue in the vessel wall of the coiled artery, which supplies blood to the uteroplacental blood pool, is replaced by fibrinous tissue with advancing gestation. Therefore uteroplacental circulation is similar to arterio-venous shunt; it is possibly important for the homeostasis of maternal blood pressure. It is known that hypoxemia results in both the redistribution of feto-placental blood flow, the increase of blood flow in the placenta, and the increase of fetal vasoactive peptides. Since placental proteases (vasopressinase and angiotensinase) degrade vasoactive peptides, placental proteases protect the placental vessels from the vasoconstriction by vasoactive peptides and might contribute to the redistribution of feto-placental blood flow. Therefore placental proteases effect on fetal blood pressure via regulation of fetal vasoactive peptides, which regulate placental blood flow. Although human and animal pregnancy is normally associated with a refractory response to the pressor effect of exogenously infused angiotensin II, patients with pre-eclampsia as well as nonpregnant women are sensitive to angiotensin II; thin phenomenon has been studied as one of the causes of pre-eclampsia. Since the administration of placental angiotensinase was effective in lowering blood pressure in rats with hypertension induced by the infusion of angiotensin II, placental proteases are possibly involved in the refractory response to exogenously infused angiotensin II.(ABSTRACT TRUNCATED AT 250 WORDS)
胎儿和母体的血压主要由体液因子、血管活性肽(如血管紧张素II和血管加压素)调节,而非自身调节和自主神经系统。已知为子宫胎盘血池供血的螺旋动脉血管壁中的正常肌弹性组织会随着孕周增加被纤维组织取代。因此,子宫胎盘循环类似于动静脉分流;这可能对母体血压的稳态很重要。已知低氧血症会导致胎儿 - 胎盘血流重新分布、胎盘血流增加以及胎儿血管活性肽增加。由于胎盘蛋白酶(血管加压素酶和血管紧张素酶)会降解血管活性肽,胎盘蛋白酶可保护胎盘血管免受血管活性肽引起的血管收缩影响,并可能有助于胎儿 - 胎盘血流的重新分布。因此,胎盘蛋白酶通过调节胎儿血管活性肽来影响胎儿血压,而胎儿血管活性肽可调节胎盘血流。尽管人类和动物妊娠通常对外源性注入血管紧张素II 的升压作用有抵抗反应,但子痫前期患者以及非孕妇对血管紧张素II敏感;这种现象已被作为子痫前期的病因之一进行研究。由于给予胎盘血管紧张素酶可有效降低因注入血管紧张素II诱导高血压的大鼠的血压,胎盘蛋白酶可能参与了对外源性注入血管紧张素II的抵抗反应。(摘要截短于250字)