不同血管保存液对人桡动脉血管移植物的抗痉挛作用

The relaxing function of different storage solutions for human radial artery

目的 研究不同的血管保存液对人离体桡动脉痉挛的缓解与预防能力。方法 非体外循环冠状动脉旁路手术(OPCAB)19例患者,应用“无接触(No Touch)”外科技术获取自体桡动脉,保留未处理的远段0.8～1.5cm。应用血管环灌流技术(Organ Bath)比较不同保存液的抗痉挛作用和预防痉挛作用。结果 血管环灌流实验显示,在对痉挛状态桡动脉的舒张能力方面,PS、VG、DG、NG溶液均可以在10min内100％舒张血管,舒张曲线显示舒张能力依次为VG、DG、NG、PS,但差异无显著性(P>0.05),在预先浸泡处理桡动脉45～60min后,除对照组(Ringer's Solution)外,所有血管保存液均可以有效地预防离体桡动脉的痉挛,各组间差异无显著性(P>0.05)。结论 罂粟碱溶液、VG、DG、NG溶液均有较好的抗血管痉挛作用,单从抗血管痉挛角度考虑可以用作CABG手术中桡动脉的准备液。

Objective To investigate the antivasospasm function of different storage solutions for human radial artery. Methods Nineteen patients underwent off pump coronary artery bypass (OPCAB) using radial artery during Jan. 2003 to March 2003. 'No touch' technique was used to get radial artery. In each patient the distal artery about 0.8-1.5 cm was cut. By using 'organ bath' technique the relaxing function of different storage solutions was evaluated. The solutions included: (1) Ringer's solution (control group) ; (2) VG solution (verapamil solution) ; (3) DG solution (diltiazem solution) ; (4) NG solution (nicardipine solution) ; (5) PS solution (papaverine solution). Results Functional research ( organ bath) showed K^+ (60 mmol/L)-induced vasoconstriction could be relaxed by all of the four storage solutions, VG, DG, NG and PS, in 10 min, and there was no difference between them (P>0.05). The contraction to K^+ (120 mmol/L) in rings treated with these 4 storage solution for 45-60 min was almost abolished. In contrast, Ringer's solution had no abilities in vasodilatation and antivasospasm (P<0.05). Conclusion Papaverine works well in vasodilatation and antivasospasm. A combination of calcium antagonists and nitroglycerin provides an excellent vascular relaxation like papaverine. All these 4 storage solutions can be used in CABG to prevent radial artery spasm only.