Shoji Fumihiro, Yano Tokujiro, Miura Naoko, Morodomi Yosuke, Yoshida Tsukihisa, Onimaru Mitsuho, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Interact Cardiovasc Thorac Surg. 2011 Sep;13(3):271-5. doi: 10.1510/icvts.2011.274480. Epub 2011 Jun 23.
Maintaining blood flow in and supplying various anti-inflammatory or angiogenic cytokines to the bronchial stump are very important factors involved in its healing. Pericardial fat pad tissue samples surgically obtained from 20 patients were assessed, and their angiogenic ability was investigated. The messenger RNA level of all angiogenic cytokines, including vascular endothelial growth factor, fibroblast growth factor-2 (FGF-2), platelet-derived growth factor-A (PDGF-A), angiopoietin-1 (Ang-1), Ang-2 and hepatocyte growth factor (HGF) were detected in the pericardial fat pad tissue. The protein levels of all cytokines except PDGF-A increased with time from day one to day seven after primary culture of the pericardial fat pad tissue. In particular, both HGF and Ang-2 protein levels on day seven were significantly higher than those on day one (P=0.0475 and P=0.0417, respectively). On the other hand, the protein level of FGF-2 decreased in time and was significantly lower on day seven than on day one (P=0.0296). The present study demonstrated the angiogenic ability of the pericardial fat pad. These results suggest that reinforcement of the bronchial stump by the pericardial fat pad is a worthwhile and justified procedure, and may prevent bronchopleural fistula after pulmonary resections.
维持支气管残端的血流并向其供应各种抗炎或血管生成细胞因子是其愈合过程中的重要因素。对20例患者手术获取的心包脂肪垫组织样本进行评估,并研究其血管生成能力。在心包脂肪垫组织中检测了包括血管内皮生长因子、成纤维细胞生长因子-2(FGF-2)、血小板衍生生长因子-A(PDGF-A)、血管生成素-1(Ang-1)、Ang-2和肝细胞生长因子(HGF)在内的所有血管生成细胞因子的信使RNA水平。心包脂肪垫组织原代培养后,从第一天到第七天,除PDGF-A外的所有细胞因子的蛋白质水平均随时间增加。特别是,第七天的HGF和Ang-2蛋白质水平均显著高于第一天(分别为P=0.0475和P=0.0417)。另一方面,FGF-2的蛋白质水平随时间下降,第七天显著低于第一天(P=0.0296)。本研究证明了心包脂肪垫的血管生成能力。这些结果表明,用心包脂肪垫加固支气管残端是一种值得且合理的做法,可能预防肺切除术后的支气管胸膜瘘。