不同保存液对静脉移植物的保护作用研究  

Protective effect of different preservation solutions on vein graft

作　　者：蒋璇[1] 李东玉[1] 罗佳文[1] 王珂[1] 李树森[1] 王文生[1] 

机构地区：[1]中国医科大学附属盛京医院心脏外科,辽宁省沈阳市110000

出　　处：《中国心血管病研究》2012年第6期457-461,480,共6页Chinese Journal of Cardiovascular Research

摘　　要：目的 探究搭桥过程中不同保存液对血管的近期及远期保护作用.方法 健康新西兰大耳兔48只,分4组.A组：GV液（维拉帕米＋硝酸甘油）组,B组：肝素化全血组,C组：罂粟碱组及D组：对照组（林格液＋肝素）.取兔颈外静脉,分别放置于不同保存液中,30 min后移植至颈内动脉.于7 d、14 d、28 d取出移植物,HE染色观察不同时期内皮增厚及中膜增生情况,计算I/M值.同时取5只兔股静脉,粗细均匀,分为40段约0.5 cm长短静脉,分别放入1 ml不同保存液中,30 min后取出静脉,Elisa法测量1 ml保存液中内皮素（ET-1）含量,HE染色观察短期保存后内皮细胞破坏情况.结果 14 d及28 d时各组比较,A组及B组血管内皮破坏及内膜增厚最轻,C组及D组内皮破坏及增生最为严重.第2周及第4周时A组及B组I/M值比较差异无统计学意义,与C组及D组比较差异有统计学意义（P＜0.05）.Elisa法测定ET-1含量,A组释放量较B组、C组、D组均明显降低（P＜0.01）,A组及B组短期保存后的血管内皮破坏情况较C组、D组要轻,内皮细胞覆盖率较高.结论 GV保存液及肝素化全血保存液可以更好地保护血管内膜,A组保存液较B、C、D组的ET-1释放量更少.Objective To explore the short and long term protective effects of different preservation solu- tions on vascular in CABG. Methods 48 New Zealand rabbits were divided into four groups, A group： GV solu- tion （verapamil＋nitroglyeefin）, B group： heparinized blood group, C papaverine group, D group：the control group （Ringer solution＋ eparin）. Rabbit jugular vein, were placed in differem preservation solutions for 30 minutes, then transplant to the carotid artery. After the transplantation, the grafts were took out on 7 days, 14 days, 28 days, the membrane thickening and endothelial byperplasia were observed at different term, the I/M values were calculated. At the same time, 12 femoral veins of 5 rabbit were took out, divided them into 40 sections of about 0.5 cm length of vein, then placed in 1 ml of different preservation solution, 30 minutes later, remove the veins, measured endothelin （ET-1） content in 1 ml preservation solution by Elisa and observe the endothelial cell dam- age after short-term preservation situation in HE staining. Results On 14 days and 28 days, A group and B group of vascular endothelial damage and intimal thickening were miniminzed, in C and D groups, the prolifera- tion and damage of endothelial cell was most severe. On 2 weeks and 4-week group, the I/M values of A group and B group have no difference compared with group C and D group （P〈0.05）. Elisa determination of ET-1 lev- els, the release of ET-2 in A group were significantly lower than group B, C and D （P〈O.01）. After the short- term preservation, the damage of vascular endothelial cells were minimized in A group and B group compared with group C, D groups, endothelial cell coverage was higher. Conclusion GV preservation solution and heparinized blood preservation solution can protect the vascular endothelium better than C group and D group. A group of preservation solution release less ET-1 than B, C, D group.

关 键 词：冠状动脉疾病 静脉移植 搭桥手术 内膜增生 保存液 动物实验 

分 类 号：Q95-33[生物学—动物学] R654.2[医药卫生—外科学]