Bolton L M, Thomas T H, Dunlop W
Department of Obstetrics and Gynaecology, University of Newcastle, Newcastle upon Tyne, UK.
Br J Obstet Gynaecol. 1996 Jun;103(6):547-51. doi: 10.1111/j.1471-0528.1996.tb09804.x.
To examine the balance of erythrocyte ions and water during the rapid changes in plasma osmolality in the early puerperium, and during the subsequent period of sustained readjustment.
A serial study from the third trimester of pregnancy to 20 weeks after delivery.
Thirty-five primiparous women who had experienced no antenatal complications.
Plasma osmolality, erythrocyte hydration, potassium, chloride and sodium were measured and nondiffusible ion content and erythrocyte membrane potential calculated. Plasma sodium, potassium and chloride were also measured.
During the first week after delivery plasma osmolality increased (280 (SEM 0.52)-289 (SEM 0.64) mosmol/kg; P < 0.001) but erythrocyte hydration did not decrease (2.060 (SEM 0.018)-2.067 (SEM 0.021) 1/kg dry cells) because of an increase in total cell osmole content (577 (SEM 5.31)-597 (SEM 6.15) mosmol/kg dry cells; P = 0.001). This increase included nondiffusible anions, chloride and potassium. These changes in ionic balance did not affect membrane potential. After the first week of the puerperium and up to the 20th week, plasma osmolality was stable but erythrocyte osmole content and hydration both decreased. This was due to a decrease in nondiffusible anions and potassium with a smaller increase in chloride leading to a decrease in membrane potential (-14.31 (SEM 0.34)mV to -12.66 (SEM 0.28)mV; P < 0.001).
A rapid increase in intracellular osmoles can occur in the mature erythrocyte and probably precedes the decrease in plasma osmolality in the puerperium. Changes in erythrocyte homeostasis in the first week of the puerperium can be accounted for by alterations in nondiffusible anions. After the first week of the puerperium it appears that the functional organisation of the membrane is changing.
研究产褥早期血浆渗透压快速变化期间以及随后持续调整阶段红细胞离子和水的平衡情况。
从妊娠晚期至产后20周的系列研究。
35名无产前并发症的初产妇。
测量血浆渗透压、红细胞水合作用、钾、氯和钠，并计算非扩散性离子含量和红细胞膜电位。同时也测量血浆钠、钾和氯。
产后第一周血浆渗透压升高（从280（标准误0.52）增至289（标准误0.64）mOsmol/kg；P<0.001），但红细胞水合作用并未降低（从2.060（标准误0.018）增至2.067（标准误0.021）1/kg干细胞），原因是细胞总渗透压含量增加（从577（标准误5.31）增至597（标准误6.15）mOsmol/kg干细胞；P = 0.001）。这种增加包括非扩散性阴离子、氯和钾。这些离子平衡的变化未影响膜电位。产褥期第一周后直至第20周，血浆渗透压稳定，但红细胞渗透压含量和水合作用均降低。这是由于非扩散性阴离子和钾减少，氯增加幅度较小，导致膜电位降低（从-14.31（标准误0.34）mV降至-12.66（标准误0.28）mV；P<0.001）。
成熟红细胞内渗透压可迅速升高，且可能先于产褥期血浆渗透压降低。产褥期第一周红细胞稳态的变化可由非扩散性阴离子的改变来解释。产褥期第一周后，似乎细胞膜的功能组织在发生变化。
