新型血管保存液对冠状动脉旁路移植术后大隐静脉桥血管早期通畅的影响  

Effect of new vascular preservation solution on the early patency of large saphenous vein bridge after coronary artery bypass grafting

作　　者：黄华 张建卿[2] 赵俊涛[2] 辛君政 姬建民 HUANG Hua;ZHANG Jianqing;ZHAO Juntao;XIN Junzheng;JI Jianmin(Xinxiang Medical University,Xinxiang 453003,China)

机构地区：[1]新乡医学院,450000 [2]郑州市第七人民医院

出　　处：《心肺血管病杂志》2024年第3期286-290,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：河南省医学科技攻关计划项目(LHGJ20191117)。

摘　　要：目的:分析一种新型血管保存液(new vascular preservation solution, NG溶液)与罂粟碱保存液对大隐静脉(great saphenous vein, GSV)桥血管内膜损伤的影响,评选出更适用于CABG的桥血管保存液。方法:选择非体外循环CABG术患者19例。采用无接触技术(no-touch technique)获取GSV,取远端血管,放置到NG溶液(实验组)和罂粟碱保存液(对照组)中,光镜观察GSV内皮细胞损伤情况,酶联免疫吸附测定法(ELISA法)测定保存液中内皮素(endothelin,ET)及血栓调节蛋白(thrombomodululin,TM)的含量,实验数据行非参数威尔科克森符号秩检验(Wilcoxon signed-rank test)。结果:两组ET显示(Z=-3.501,P <0.001),差异有统计学意义;可认为ET在NG溶液中含量较少。TM显示(Z=-1.610,P=0.107),差异无统计学意义;TM在NG溶液和常规罂粟碱保存液中无明显差别。光镜下评估两组血管内皮损伤情况得分结果显示(Z=-1.966,P=0.049),差异有统计学意义;可认为在NG溶液中的GSV内皮损伤较小。结论:NG溶液对防止GSV桥血管早期再狭窄情况的发生有一定改善作用。Objective:The effect of the new vascular preservation solution(NG solution)and papaverine preservation solution on the intimal injury of the bridge vein of the great saphenous veins(GSV)was analyzed,we will select the vascular preservation solution that is more suitable for CABG.Methods:A total of 19 patients with CABG off cardiopulmonary bypass non extracorporeal circulation(off-pump)were selected.GSV was obtained by no-touch technique,distal blood vessels were taken and placed into NG solution(experimental group)and papaverine preservation solution(control group).GSV endothelial cell damage was observed by light microscopy,and the content of endothelin(ET)and thrombomodulin(TM)in the preservation solution was determined by enzyme-linked immunosorbent assay(ELISA),experimental data were subjected to a non-parametric Wilcoxon signed-rank test(Wilcoxon signed-rank test).Results:ET showed(Z=-3.501,P<0.001),there was statistical significance;it can be considered less in NG solution.TM(Z=-1.610,P=0.107),no statistical significance;no obvious of TM in NG solution and papaverine preservation solution.The score of vascular endothelial injury evaluation under light microscope showed that(Z=-1.966,P=0.049),which was statistically significant;GSV endothelial damage can be considered less in NG solution.Conclusions:NG solution improved the occurrence of early restenosis of GSV bridge vessels.

关 键 词：内皮素 血栓调节蛋白 大隐静脉 新型血管保存液 罂粟碱保存液 

分 类 号：R54[医药卫生—心血管疾病]