3种常用扩血管药物对预防桡动脉痉挛作用的实验研究

目的比较硝酸甘油(NTG)、维拉帕米(VP)和罂粟碱(PA)3种药物对人桡动脉的解痉作用。方法收集冠状动脉旁路移植手术桡动脉标本,采用组织浴槽方法,分别比较3种药物成分对离体痉挛桡动脉的治疗作用和经过药物预处理后桡动脉发生痉挛情况。结果在对痉挛状态桡动脉的舒张能力方面,VP、NTG和PA溶液均可以在11min内使桡动脉完全舒张,但在最初的3min内,NTG的舒张效果明显好于其他2组。舒张曲线显示舒张能力依次为NTG>VP>PA。在桡动脉预处理抗痉挛试验中,VP与NTG和PA2组比较差异显著(P<0.05)。冷藏24h后,VP仍能预防血管痉挛(P<0.05),而NTG和PA组几乎没有作用,后二者与对照组比较差异不显著(P>0.05)。结论3种药物最终都能不同程度地预防和缓解桡动脉的痉挛,应用NTG缓解治疗已经痉挛的桡动脉效果比较明显;应用VP对桡动脉进行预处理,能够在一定程度上预防桡动脉的痉挛。

Experimental Study on Relieving and Preventing Vasospasm in Radial Artery of Nitroglycerin, Verapamil and Papaverine

Objective To compare the antispastic effects of nitroglycerin (NTG),verapamil(VP) and papaverine(PA) on human radial arteries. Methods The radial arteries of patients having accepted the operation of coronary artery bypass grafting (CABG) were collected post operation. The therapeutical effect of NTG,VP and PA on spasm of isolated radial arteries and the relaxing function of radial arteries were evaluated by "organ bath" technique. Results The radial arteries in NTG ,VP and PA solutions were relaxed in 11 min after vasospasm and there was no difference between them (P > 0.05). But during the initial three minutes,the relaxation effect of NTG was significantly better than other two groups. Relaxation curve showed that the ability of vasodilatation of NTG,VP and PA decreased in order. In the experiment about antivasospasm pretreatment of radial arteries,the effects of VP group were better than NTG and PA group(P < 0.05). After cold storage for 24 h,VP still could prevent vasospasm. But NTG and PA hardly had any function and there was no difference compared with the control group (P > 0.05). Conclusion Although in the final all these drugs could prevent and relieve vasospasm of radial arteries in the different level,it appeared that nitroglycerin was more fit for treating spastic radial artery than other drugs. Then verapamil could prevent spasm of radial artery by pretreatment on a certain degree.