Cook J M, Cook C D, Marlar R, Solis M M, Fink L, Eidt J F
Department of Surgery, John L. McClellan Veterans Administration Hospital, Little Rock, AR 72205.
J Vasc Surg. 1991 Aug;14(2):147-51. doi: 10.1067/mva.1991.28730.
Thrombomodulin, a membrane glycoprotein present on normal vascular endothelium, binds circulating thrombin and is important in protein C activation. These functions contribute to the nonthrombogenic nature of endothelium. Damage during harvest and ex vivo storage of vein grafts may result in dysfunction of this endothelial anticoagulant barrier and possibly contribute to early graft thrombosis. We studied the functional activity and antigenic expression of thrombomodulin on saphenous veins before (initial) and after (harvested) harvest and storage for coronary artery bypass grafting in 15 patients. Also, fresh saphenous vein was studied after mechanical endothelial stripping. After storage for 2.7 +/- 0.6 hours at room temperature in heparinized saline, thrombomodulin functional activity in harvested vein segments was 28% less than initial segments (p = 0.08). Endothelial stripping resulted in a 79% reduction in thrombomodulin activity compared with initial segments (p = 0.04). Immunohistochemical staining confirmed thrombomodulin antigen on vein grafts after harvest and storage, but not on segments stripped of endothelium. Thrombomodulin functional activity and antigenic expression on human saphenous vein grafts is not significantly changed by harvest and relatively short periods of storage at room temperature in heparinized saline.
血栓调节蛋白是一种存在于正常血管内皮细胞上的膜糖蛋白，它能结合循环中的凝血酶，在蛋白C激活过程中起重要作用。这些功能有助于维持内皮细胞的非血栓形成特性。静脉移植物在采集和体外储存过程中受到的损伤可能导致这种内皮抗凝屏障功能失调，并可能促成早期移植物血栓形成。我们研究了15例患者用于冠状动脉搭桥术的大隐静脉在采集前（初始状态）以及采集和储存后（采集后）血栓调节蛋白的功能活性和抗原表达情况。此外，还对机械去除内皮后的新鲜大隐静脉进行了研究。在肝素化盐水中于室温下储存2.7±0.6小时后，采集的静脉段中血栓调节蛋白的功能活性比初始段降低了28%（p = 0.08）。与初始段相比，去除内皮导致血栓调节蛋白活性降低了79%（p = 0.04）。免疫组织化学染色证实，采集和储存后的静脉移植物上存在血栓调节蛋白抗原，但去除内皮的段上没有。采集以及在肝素化盐水中于室温下相对短时间的储存，并未显著改变人隐静脉移植物上血栓调节蛋白的功能活性和抗原表达。
