Hayashida Nobuhiko, Teshima Hideki, Tayama Eiki, Chihara Shingo, Enomoto Naofumi, Kawara Takemi, Aoyagi Shigeaki
Department of Surgery, Kurume University, Fukuoka, Japan.
Circ J. 2002 Apr;66(4):372-6. doi: 10.1253/circj.66.372.
The effect of colforsin daropate hydrochloride (colforsin), a water-soluble forskolin derivative, on blood flow in internal mammary artery (IMA) grafts was evaluated in a prospective randomized study of 26 patients undergoing coronary artery bypass grafting. Patients were randomized to receive either colforsin treatment (colforsin; n=14) or no colforsin treatment (control; n=14). Administration of colforsin (0.5mg x kg(-1) min(-1)) was started after induction of anesthesia and was continued for 6 h. IMA blood flow and hemodynamic measurements were assessed perioperatively. During cardiopoulmonary bypass (CPB), perfusion flow was adjusted to 2.5 L/m2 and IMA free blood flow was measured. IMA blood flow was also measured 1 h after CPB by an ultrasonic flow meter. Systemic vascular resistance was significantly lower in the colforsin group during and after CPB. IMA blood flow was significantly greater in the colforsin group than in the control group during (44 +/- 2 vs 33 +/- 3 ml min-1 x m(-2), p=0.02) and after CPB (38 +/- 6 vs 20 +/- 3ml x min(-1) m(-2), p=0.01). IMA blood flow 1 h after CPB correlated inversely with concurrent systemic vascular resistance (r=-0.61, p=0.001). Intraoperative administration of colforsin daropate hydrochloride caused potent vasodilation, resulting in an increase in IMA blood flow. The results indicate that the regimen can be used perioperatively in patients undergoing coronary artery bypass grafting.
在一项针对26例接受冠状动脉旁路移植术患者的前瞻性随机研究中，评估了水溶性福司可林衍生物盐酸可乐福辛（colforsin）对乳内动脉（IMA）移植物血流的影响。患者被随机分为接受可乐福辛治疗组（可乐福辛组；n = 14）或不接受可乐福辛治疗组（对照组；n = 14）。麻醉诱导后开始给予可乐福辛（0.5mg·kg⁻¹·min⁻¹），并持续6小时。围手术期评估IMA血流和血流动力学指标。在体外循环（CPB）期间，将灌注流量调整至2.5 L/m²，并测量IMA游离血流。CPB后1小时也通过超声流量计测量IMA血流。在CPB期间及之后，可乐福辛组的全身血管阻力显著降低。在CPB期间（44±2 vs 33±3 ml·min⁻¹·m⁻²，p = 0.02）和CPB后（38±6 vs 20±3ml·min⁻¹·m⁻²，p = 0.01），可乐福辛组的IMA血流显著高于对照组。CPB后1小时的IMA血流与同期全身血管阻力呈负相关（r = -0.61，p = 0.001）。术中给予盐酸可乐福辛可引起强效血管舒张，导致IMA血流增加。结果表明，该方案可在接受冠状动脉旁路移植术的患者围手术期使用。
