Sisto T, Ylä-Herttuala S, Luoma J, Riekkinen H, Nikkari T
Department of Thoracic and Cardiovascular Surgery, University Central Hospital, Tampere, Finland.
J Vasc Surg. 1990 Mar;11(3):418-22. doi: 10.1067/mva.1990.17248.
The long-term patency of the internal mammary artery graft is better than that of the saphenous vein graft in coronary bypass surgery because of a low incidence of atherosclerosis in the internal mammary artery. In search of a possible biochemical explanation of the low degree of atherosclerosis in the internal mammary artery we compared the chemical compositions of human internal mammary artery and saphenous vein obtained from 37 patients undergoing coronary bypass surgery. The levels of esterified cholesterol and free cholesterol were higher in the internal mammary artery than in the saphenous vein (p less than 0.001 and p less than 0.01, respectively), but lower than the levels reported in previous studies for coronary arteries. The amount of collagen was higher in the saphenous vein (p less than 0.001). Heparan sulfate was the major glycosaminoglycan fraction in the internal mammary artery, probably reflecting the higher cellularity and thicker media in the arterial rather than in the venous tissue. The level of dermatan sulfate was higher (p less than 0.001) in the saphenous vein than in the internal mammary artery. This difference is in a direction that could favor atherogenesis in the saphenous vein graft.
在冠状动脉搭桥手术中,由于乳内动脉粥样硬化发生率较低,其移植血管的长期通畅性优于大隐静脉移植血管。为了寻找乳内动脉粥样硬化程度较低的可能生化解释,我们比较了37例行冠状动脉搭桥手术患者的人乳内动脉和大隐静脉的化学成分。乳内动脉中酯化胆固醇和游离胆固醇的水平高于大隐静脉(分别为p<0.001和p<0.01),但低于先前关于冠状动脉研究报道的水平。大隐静脉中胶原蛋白的含量较高(p<0.001)。硫酸乙酰肝素是乳内动脉中主要的糖胺聚糖成分,这可能反映了动脉组织而非静脉组织中较高的细胞密度和较厚的中层。大隐静脉中硫酸皮肤素的水平高于乳内动脉(p<0.001)。这种差异的方向可能有利于大隐静脉移植血管发生动脉粥样硬化。