The vascular cast of the human uterus - From anatomy to physiology
The vascular cast of the human uterus - From anatomy to physiology
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DOI：
10.1196/annals.1335.002
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发表时间：
2004-01-01
期刊：
影响因子：
--
通讯作者：
Nicoletti, R
中科院分区：
文献类型：
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作者：
Cicinelli, E;Einer-Jensen, N;Nicoletti, R
子宫的血液供应主要来自子宫动脉。然而，子宫动脉和卵巢动脉形成双侧吻合。关于吻合中的血流方向以及子宫输卵管和输卵管部分的动脉供应来源存在争议。阴道动脉和子宫动脉也形成类似的拱廊。我们研究了绝经后妇女子宫动脉和卵巢动脉之间的供应血管边界，该边界位于子宫内距输卵管 1-2 厘米处。在年轻、排卵期的女性中也发现了类似的结果。然而，在卵泡期和黄体期，子宫动脉和卵巢动脉灌溉的区域之间的边界是不同的。当存在大卵泡时，更多的子宫组织从卵巢动脉灌注。这是对两个血管系统的领土划分的功能决定转变的首次描述，并且具有许多实际意义。静脉系统复制动脉系统，但有一个主要例外：一些子宫静脉连接卵巢出口。静脉和动脉之间的紧密接触有利于物质的转移，从而形成半局部的调节系统；例如，卵巢局部影响同侧输卵管和部分子宫的功能。从治疗的角度来看，已有文献记载，由于局部血管转移，将孕酮施用于阴道会产生高子宫浓度。
The blood supply to the uterus originates mainly from the uterine artery. However, the uterine and ovarian arteries form anastomoses bilaterally. Controversy exists about the direction of the flow in the anastomoses and thus the origin of the arterial supply to the tube and tubal part of the uterus. A similar arcade is formed by the vaginal and uterine arteries. We have investigated the vascular border of supply between the uterine and ovarian arteries in postmenopausal women, which was positioned in the uterus 1-2 cm from the tube. A similar result was found in younger, ovulating women. However, the border between the territories irrigated by the uterine and ovarian arteries differs between the follicular and luteal phase; more uterine tissue is perfused from the ovarian artery when a large follicle is present. This constitutes the first description of a functionally determined shift in the territorial divide of two vascular systems and has numerous practical implications. The venous system copies the arterial one with one major exception: some of the uterine veins join the ovarian outlet. The close contact between veins and arteries facilitates transfer of substances, thus forming semilocal systems of regulation; for example, the ovary locally influences the function of the ipsilateral tube and part of the uterus. From a therapeutic point of view, it has been documented that application of progesterone to the vagina creates high uterine concentrations due to local vascular transfer.