吸烟对血管损伤机制的研究  

Damaging effects of smoking on blood vessels

作　　者：王涛[1,2] 顾玉东[1,2] 李继峰[1,2] 吴淦桐[1,2] 

机构地区：[1]上海医科大学华山医院手外科 [2]上海医科大学药理教研室

出　　处：《中华手外科杂志》1998年第1期5-7,共3页Chinese Journal of Hand Surgery

基　　金：美国中华医学基金;上海市领先学科基金

摘　　要：目的探讨因吸烟致移植或再植组织发生血循环危象的机制。方法（１）对因吸烟而致血循环危象的７例断指再植、组织移植病例进行总结分析。（２）对大鼠进行被动吸烟实验，分成术前被动吸烟组、术后被动吸烟组及正常对照组。应用检测离体血管舒缩功能的方法及扫描电镜技术，观察吸烟对大鼠血管吻合口内皮细胞的愈合过程；尼古丁对离体动脉的舒缩功能及血管内膜完整性的影响。结果临床７例各自在术后不同时间吸烟１次后，３例移植组织和４例再植组织发生血循环危象。实验结果表明：（１）血管吻合后１０天，吸烟组血管吻合口内皮细胞覆盖率为２８％～３２％，而对照组达８５％。（２）尼古丁能使血管环产生浓度依赖性收缩，并且造成血管内皮结构的严重破坏。结论吸烟能延缓内皮细胞愈合、血管收缩与损伤血管内膜。Objective To investigate the mechanism of circulation crisis caused by smoking in tissue transfer or replantation. Methods (1) Seven cases of tissue transfer or replantation which sustained circulation crisis caused by smoking were reviewed and analysed. (2) Adopting relaxation and contraction functional test of isolated blood vessels and scanning electron microscopic techniques, the endothelial healing processes at arterial anastomosis sites in rats and the influence of nicotine on contraction and relaxation function and the integrity of intima of isolated arteries were observed. Results After smoking, circulation crisis occured in 3 cases of tissue transfer and 4 cases of replantation. The experimental study showed that the endothelial healing rates of vascular anastomosis sites were 28%～32% in the smoking group , and 85% in the control group at 240 hours after the operation. Nicotine not only brought about a concentration dependent constriction response, but also caused severe damage to the vascular intima. Conclusions Smoking delays endothelial healing processes, contracts blood vessels, and injures vascular intima. Smoking is an important factor causing circulation crisis in tissue transfer and replantation.

关 键 词：吸烟 血栓形成 血管内膜 再植术 组织移植 

分 类 号：R163[医药卫生—公共卫生与预防医学] R543.02