米力农、酚苄明、硝酸甘油与维拉帕米混合液预防与治疗人桡动脉痉挛的实验研究  

Comparison of Milrinone,Phenoxybenzamine,and Mixture of Nitroglycerin and Verapamil for the Prevention and Treatment of Human Radial Artery Spasm

作　　者：祝岩[1] 王辉山[1] 李新民[1] 王丽慧[1] 汪曾炜[1] 

机构地区：[1]沈阳军区总医院心血管外科解放军心脏血管外科研究所,沈阳110016

出　　处：《中国胸心血管外科临床杂志》2013年第2期198-203,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：辽宁省自然科学基金资助项目(201225014)~~

摘　　要：目的研究比较米力农(MIN)、酚苄明(PHE)、硝酸甘油与维拉帕米混合液(NVC)对人桡动脉痉挛的预防与治疗作用。方法收集2012年3～9月在沈阳军区总医院采用自体桡动脉行冠状动脉旁路移植术(CABG)30例患者的剩余桡动脉,制成60个宽3 mm左右的血管环并悬挂在Organ-Bath水浴槽中,将其按照随机数字表法分成4组:MIN组,PHE组,NVC组和空白对照组(对照组)。先取20个血管环进行痉挛缓解实验,每组5个。用终浓度为10-3mol/L的苯肾上腺素致血管环痉挛,分别加入PHE浓度为1 mmol/L、MIN浓度为30μmol/L、NVC浓度各为30μmol/L,对照组中加入Krebs-Ringer’s缓冲液,观察比较不同血管舒张药对痉挛血管的舒张能力;然后另取40个血管环进行药物预处理作用时间对比实验,每组10个,血管环在不同药物中分别浸泡30 min后立即加入终浓度为10-3mol/L的苯肾上腺素,观察和描记经过预处理后血管环发生收缩程度随时间改变的情况。结果在血管环痉挛缓解实验中,NVC组痉挛血管环缓解最为迅速(P<0.01),给药3 min后缓解率达99.14%;MIN组血管环缓解稍慢而平稳(P<0.05),3 min时缓解率达40.73%,9 min时达96.83%,至第11 min时完全缓解;PHE组缓解血管痉挛最为缓慢(P<0.01):3 min时缓解了10.38%,9 min时缓解了78.61%,至17 min时才达到完全缓解;对照组无缓解。在桡动脉血管环预处理实验中,对照组在加入苯肾上腺素后立即产生收缩(痉挛),收缩率10%;MIN组也立即产生收缩,但收缩幅度较对照组缓慢(P<0.01),120 min收缩45.81%,240 min收缩63.28%;NVC组血管环在实验开始时没有立即产生收缩,直到120 min后血管环静息张力才逐渐增大,至240 min实验结束时收缩程度为46.89%;PHE组在整个实验过程中没有产生任何收缩。结论几种药物成分都能不同程度地预防和缓解桡动脉痉挛,但每种药物作用特点、缓解痉挛程度以及作用的时效性明显不同。NVC对缓解已经痉挛的桡�Objective To compare milrinone （MIN）, Phenoxybenzamine （PHE）, and mixture of nitroglycerin and verapamil（NVC） for the prevention and treatment of human radial artery spasm. Methods Residuary radial arteries from 30 patients undergoing coronary artery bypass grafting （CABG） using autologous radial artery from March to September of 2012 in General Hospital of Shenyang Military District were collected. All the artery specimens were cut into 60 vessel rings of 3 mm in width and hanged in the Organ-Bath. Using a random number table, all the vessel rings were divided into 4 groups： PHE group, NVC group, MIN group and blank group （control group）. Firstly, 20 vessel rings were used for spasm relaxation experiment with 5 rings in each group. Phenylephrine was added into the Organ-Bath to reach final concentration of 103 mol/Lin order to cause vessel rings spasm. PHE of 1 mmol/L, NVC of both 30 μmol/L, MIN of 30μmol/L and Krebs-Ringer＇s solution were added respectively into above groups to compare the relaxant effect of these vasodilators on radial artery spasm. Secondly, the other 40 vessel rings were used for spasm prevention experiment with 10 rings in each group. All the 40 vessel rings were dipped in above 4 groups. After 30 minutes, phenylephrine was added to the Organ-Bath to reach final concentration of 10^-3 mol/L. Time-dependent constriction of the vessel rings were compared to examine the prevention effect of these vaso- dilators on radial artery spasm. Results In the spasm relaxation experiment, vessel ring spasm relaxed most quickly in NVC group （P 〈 0.01 ）. Vessel rings in MIN group relaxed more slowly but steadily （P 〈 0.05）. Vessel rings in PHE group relaxed most slowly （P 〈 0.01 ）. And there was no relaxation in the control group. In the spasm prevention experiment, vessel rings in the control group contracted （spasm） 100% immediately after phenylephrine administration. Vessel rings in MIN group contracted immediately after phenylephrine administration too,

关 键 词：冠状动脉旁路移植术 桡动脉 痉挛 米力农 酚苄明 硝酸甘油 维拉帕米 

分 类 号：R543.5[医药卫生—心血管疾病]