罂粟碱和硝酸甘油对乳内动脉血管内皮的影响

目的对左乳内动脉(left internal mammary artery,LIMA)行局部腔内注射罂粟碱和硝酸甘油,将LIMA末端废弃的血管环行器官浴槽实验,研究2种药物对动脉血管内皮的影响。结果将50例行LIMA和前降支(left anterior descending,LAD)吻合的不停跳冠状动脉旁路移植术患者随机分为2组,罂粟碱组和硝酸甘油组,每组25例。不接触技术采集LIMA后分别行腔内注射3 mg/3 mL浓度剂量的自体肝素全血罂粟碱和硝酸甘油,分别测定:80 mmol/L的KCl、3种浓度(10-7mol/L、10-6mol/L、10-5mol/L)去甲肾上腺素(norepinephrine,NE)刺激下的血管平滑肌收缩反应;3种浓度(10-7mol/L、10-6mol/L、10-5mol/L)乙酰胆碱(acetylcholine,Ach)诱导下的内皮依赖性血管舒张反应。结果两组血管环对80 mmol/L的KCl最大收缩反应张力和对3种浓度(10-7mol/L、10-6mol/L、10-5mol/L)去甲肾上腺素(NE)的平均收缩百分比差异无统计学意义。两组血管环对3种浓度(10-7mol/L、10-6mol/L、10-5mol/L)乙酰胆碱(Ach)的平均舒张百分比差异无统计学意义。结论该浓度剂量的自体肝素全血罂粟碱和硝酸甘油均不会改变乳内动脉血管内皮功能。

Influence of papaverine and nitroglycerin on endothelium of left internal mammary artery

Objective To evaluate the effect of intraluminal injection of papaverine and nitroglycerin on endothelial function of the pedicle left internal mammary artery(LIMA) after preparation through organ bath.Methods The study comprised of 50 patients who underwent harvesting of the LIMA as a graft to the left anterior descending coronary artery in preparation for off-pump coronary bypass grafting. The LIMA was harvested by no-touch technique. The patients were randomly subdivided into two treatment groups and each had 25 patients. Three mg/3 mL heparinized autologous blood papaverine and nitroglycerin were intraluminally injected. The LIMA endothelium function was examined in isolated organ baths. Contractile function of arterial rings were obtained by using potassium (KCl 80 mmol/L) and three different concentration (10^-7 mol/L -10^-5 mol/L) of norepinephrine (NE) after intraluminal injection of these two vasodilators. Endothelium-dependent diastolic response was tested in response of 10^-7 mol/L -10^-5 mol/L acetylcholine (Ach).ResultsThe maximum contraction forces in response to 80 mmol/L KCl were not significantly different between papaverine and nitroglycerin (P=0.957); the relative vasoconstriction of papaverine and nitroglycerin after cumulative concentration of NE,10^-7mol/L (P=0.276), 10^-6 mol/L (P=0.396) and 10^-5 mol/L (P=0.554), they all showed no significant differences; endothelium dependent relaxation percentage with cumulative relaxation concentration Ach, 10^-7mol/L (P=0.299),10^-6 mol/L(P=0.163)and 10^-5 mol/L(P=0.089),was not significantly different. Conclusion The results suggest that IMA 3 mg/3 mL heparinized autologous blood papaverine and nitroglycerin as topical intraluminal vasodilators did not induce functional change of the artery.