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血小板与动脉和静脉冠状动脉搭桥血管的不同相互作用。

Different interactions of platelets with arterial and venous coronary bypass vessels.

作者信息

Yang Z H, Stulz P, von Segesser L, Bauer E, Turina M, Lüscher T F

机构信息

Department of Research, University Hospital, Basel, Switzerland.

出版信息

Lancet. 1991 Apr 20;337(8747):939-43. doi: 10.1016/0140-6736(91)91571-b.

Abstract

We studied the interaction of platelets with the wall of human internal mammary arteries and saphenous veins, suspended in organ chambers for measurement of isometric tension. Vessels were obtained during coronary bypass surgery and cut into 5 mm rings; in some the endothelium was chemically removed. Rings from several patients were randomly chosen for each experiment, and in each ring six concentrations of platelets (from healthy blood donors; 1-75 x 10(3)/microliters) were tested consecutively and concentration-response curves constructed; the areas under these curves were used for statistical comparisons. In rings of internal mammary artery contracted in response to noradrenaline, aggregating platelets induced endothelium-dependent relaxation which was prevented by apyrase (0.67 U/ml ADPase activity) and L-NG-monomethylarginine (1 mmol/l). By contrast, in saphenous vein rings contracted in response to noradrenaline, aggregating platelets induced only a further increase in tension. In quiescent vessels, the platelet-induced contraction did not occur in arteries with endothelium but that in veins was greater and facilitated by endothelium. Preincubation of platelets with aspirin (10 mumol/l) reduced the contraction in both vessels, but contraction was abolished only in the presence of both the thromboxane receptor antagonist SQ-30741 and the serotoninergic (5HT2) receptor antagonist ketanserin. These findings show that platelet-derived ADP causes release of nitric oxide by the endothelium of internal mammary artery but not of saphenous vein; thromboxane A2 and serotonin mediate contraction in vein but not artery with endothelium. These differences may contribute to differences in graft function and the clinical efficacy of antiplatelet drugs.

摘要

我们研究了悬浮于器官腔室中用于测量等长张力的人乳内动脉和大隐静脉壁与血小板之间的相互作用。血管取自冠状动脉搭桥手术过程中,切成5毫米的环;部分血管的内皮通过化学方法去除。每次实验从几名患者的血管环中随机选取,在每个血管环中连续测试六种浓度的血小板(来自健康献血者;1 - 75×10³/微升),并构建浓度 - 反应曲线;这些曲线下的面积用于统计比较。在对去甲肾上腺素产生收缩反应的乳内动脉环中,聚集的血小板诱导内皮依赖性舒张,这种舒张被腺苷三磷酸双磷酸酶(0.67 U/ml ADP酶活性)和L - NG - 单甲基精氨酸(1 mmol/l)所抑制。相比之下,在对去甲肾上腺素产生收缩反应的大隐静脉环中,聚集的血小板仅导致张力进一步增加。在静息血管中,血小板诱导的收缩在有内皮的动脉中不发生,但在静脉中更大且内皮可促进这种收缩。用阿司匹林(10 μmol/l)预孵育血小板可降低两种血管中的收缩,但仅在同时存在血栓素受体拮抗剂SQ - 30741和5 - 羟色胺能(5HT2)受体拮抗剂酮色林时收缩才被消除。这些发现表明,血小板衍生的ADP可导致乳内动脉内皮释放一氧化氮,但大隐静脉内皮则不会;血栓素A2和5 - 羟色胺介导静脉收缩,但不介导有内皮动脉的收缩。这些差异可能导致移植物功能差异以及抗血小板药物临床疗效的不同。

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