不同血管活性药物在冠状动脉旁路移植手术中的实验研究  

Empirical Study of Different Vasoactive Agents in Coronary Artery Bypass Graft Surgery

作　　者：祝岩[1] 王辉山[1] 李新民[1] 肖月华[1] 

机构地区：[1]沈阳军区总医院心脏血管外科,沈阳110016

出　　处：《临床误诊误治》2013年第1期52-55,共4页Clinical Misdiagnosis & Mistherapy

基　　金：辽宁省自然科学基金资助项目(201225014)

摘　　要：目的比较米力农、酚苄明和硝酸甘油对人桡动脉痉挛的防治作用。方法收集20例冠状动脉旁路移植手术(CABG)者的桡动脉标本,制成3 mm宽的血管环。利用Organ-Bath技术比较米力农(米力农组)、酚苄明(酚苄明组)、硝酸甘油(硝酸甘油组)对离体痉挛桡动脉的治疗作用,并观察经药物预处理后桡动脉对致痉挛因素刺激的反应情况。结果痉挛缓解实验中,硝酸甘油在痉挛桡动脉完全舒张时间上最迅速有效,与米力农和酚苄明比较差异有统计学意义(P<0.01);酚苄明与米力农比较差异亦有统计学意义(P<0.01);3组药物组均较空白对照组有效(P<0.01)。痉挛预防实验中,酚苄明组产生静息张力的平均药物剂量明显低于硝酸甘油组与米力农组(P<0.05);硝酸甘油组与米力农组比较无统计学意义(P>0.05);3组药物组与空白对照组比较均有统计学意义(P<0.05)。结论米力农、酚苄明、硝酸甘油都能不同程度地预防和缓解桡动脉痉挛,硝酸甘油对缓解已痉挛的桡动脉最有效,而经酚苄明预处理的桡动脉最不易产生新的痉挛。Objective To compare preventive and therapeutic effects of milrinone, phenoxybenzamine and nitroglycerin on human radial artery spasm. Methods The radial artery samples of 20 patients who underwent coronary artery bypass graft surgery （CABG） were collected, and were cut into 3 mm wide of circulus vasculosuses. The therapeutical effects for excised spasm radial artery of Milrinone （MIN group）, phenoxybenzamine （PHE group） and nitroglycerin （NTG group） were compared by Organ Bath technique, and irritative reactions of radial arteries with medicamentous pretreatment to cause spasm factors were observed. Results In relaxed spasm experiment, the completely relaxed time of radial arteries in NTG group was the fastest, and the differences be- tween NTG group with MIN and PHE groups were of statistical significance （P 〈 0. 01 ） ; the difference between PHE and MIN groups was also of statistical significance （P 〈0. 01 ） ; the effects of the 3 drug groups were better than that of control group （P 〈 0. 01 ）. In preventive spasm experiment, the average drug dose of producing resting tension in PHE group was significantly lower than those of NTG and MIN groups （P 〈 0. 05） ; the difference between NTG and M1N groups was of no statistical significance （P 〉 0. 05） ; the differences of the 3 drug groups and control group were of statistical significance （P 〈0. 05）. Conclusion Milrinone, phenoxybenzamine and nitroglycerin can prevent and relieve vasospasm of radial arteries in different levels, and the NTG can effec- tively release the spasmed radial arteries, while the PHE can do a wonderful job in pretreatment proeedure. [

关 键 词：冠状动脉旁路移植术 桡动脉 痉挛 硝酸甘油 酚苄明 米力农 

分 类 号：R654.2[医药卫生—外科学]