Zachrisson H, Lindenberger M, Hallman D, Ekman M, Neider D, Länne T
Department of Clinical Physiology, University Hospital, Linköping, Sweden.
Clin Physiol Funct Imaging. 2011 Jul;31(4):300-6. doi: 10.1111/j.1475-097X.2011.01016.x. Epub 2011 Mar 29.
The greater saphenous vein (GSV) is commonly used in autologous vein graft surgery. GSV diameter has proven to influence graft patency, and furthermore venous compliance might be of importance. The purpose of the study was to evaluate the effect of age on GSV diameter and compliance, and to evaluate the effect of nitroglycerine (NTG).
The diameter and compliance of the GSV, with and without NTG, were examined with B-mode ultrasound in 12 elderly (70·3 ± 1·2 year) and 15 young (25·1 ± 0·6 year) men. The GSV diameter at the thigh and calf level was measured at rest, after 6 min of venous stasis (60 mmHg) and after NTG administration. Pressure-area curves during a linear venous pressure decrease were produced. Venous compliance was calculated using the quadratic regression equation (area) = β(0) + β(1) (cuff pressure) + β(2) (cuff pressure)(2) .
GVS diameter between the groups showed significant lower diameter in elderly compared to young men (P<0·05). Venous occlusion increased GSV diameter in elderly men (P<0·01) as well as young men (P<0·001). NTG increased GSV diameter in elderly men (P<0·01) with an equal trend in young men. During venous occlusion, after administration of NTG, GSV diameter increased further in both elderly (P<0·01) and young men (P<0·001). GSV compliance was decreased in elderly (β(1) , 0·037 ± 0019, β(2,) -0·000064 ± 00017) versus young men (β(1) , 0·128 ± 0·013, β(2) , -0·00010 ± 000018) [P<0·001 (β(1) ), P<0·02 (β(2) )].
Baseline GSV diameter as well as GSV compliance is decreased in elderly men compared to the young subjects. As reduced GSV diameter as well as reduced compliance is related to decreased graft patency, these findings might be of importance for the uses of GSV as graft material in cardiovascular bypass surgery. The clinical value has to be clarified in future studies.
大隐静脉（GSV）常用于自体静脉移植手术。已证实GSV直径会影响移植血管通畅性，此外静脉顺应性可能也很重要。本研究的目的是评估年龄对GSV直径和顺应性的影响，以及评估硝酸甘油（NTG）的作用。
采用B型超声检查12名老年男性（70.3±1.2岁）和15名年轻男性（25.1±0.6岁）在使用和未使用NTG情况下的GSV直径和顺应性。在静息状态、静脉淤滞6分钟（60 mmHg）后以及给予NTG后，测量大腿和小腿水平的GSV直径。生成线性静脉压力降低过程中的压力-面积曲线。使用二次回归方程（面积）=β(0)+β(1)（袖带压力）+β(2)（袖带压力）²计算静脉顺应性。
两组之间，老年男性的GSV直径显著低于年轻男性（P<0.05）。静脉阻塞使老年男性（P<0.01）和年轻男性（P<0.001）的GSV直径均增加。NTG使老年男性的GSV直径增加（P<0.01），年轻男性有相同趋势。在静脉阻塞期间，给予NTG后，老年男性（P<0.01）和年轻男性（P<0.001）的GSV直径进一步增加。老年男性（β(1)，0.037±0.019，β(2)，-0.000064±0.0017）的GSV顺应性低于年轻男性（β(1)，0.128±0.013，β(2)，-0.00010±0.000018）[P<0.001（β(1)），P<0.02（β(2)）]。
与年轻受试者相比，老年男性的GSV基线直径和顺应性降低。由于GSV直径减小以及顺应性降低与移植血管通畅性降低有关，这些发现可能对GSV作为心血管搭桥手术移植材料的应用具有重要意义。其临床价值有待未来研究阐明。
