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甲磺酸萘莫司他：它能否用作冠状动脉搭桥手术中的血管桥保护剂？

Nafamostat mesilate: can it be used as a conduit preserving agent in coronary artery bypass surgery?

作者信息

Yoon Yoo Sang, Oh Hyunkong, Kim Yonghwan, Lim Seung Pyung, Kim Cuk-Seong, Kang Min-Woong

机构信息

Department of Thoracic Surgery, Dongnam Institute of Radiological and Medical Science, Korea.

Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Korea.

出版信息

Korean J Thorac Cardiovasc Surg. 2013 Dec;46(6):413-25. doi: 10.5090/kjtcs.2013.46.6.413. Epub 2013 Dec 6.

DOI:10.5090/kjtcs.2013.46.6.413
PMID:24368967
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3868688/
Abstract

BACKGROUND

Graft vessel preservation solution in coronary artery bypass surgery is used to maintain the graft conduit in optimal condition during the perioperative period. Nafamostat mesilate (NM) has anticoagulation and anti-inflammatory properties. Therefore, we investigated NM as a conduit preservative agent and compared it to papaverine.

METHODS

Sprague-Dawley (SD) rat thoracic aortas were examined for their contraction-relaxation ability using phenylephrine (PE) and acetylcholine (ACh) following preincubation with papaverine and NM in standard classical organ baths. Human umbilical vein endothelial cells (HUVECs) were cultured to check for the endothelial cell viability. Histopathological examination and terminal deoxynucleotidyl transferase dUTP nick end labeling assay were performed on the thoracic aortas of SD rats.

RESULTS

The anti-contraction effects of papaverine were superior to those of NM at PE (p<0.05). The relaxation effect of NM on ACh-induced vasodilatation was not statistically different from that of papaverine. Viability assays using HUVECs showed endothelial cell survival rates of >90% in various concentrations of both NM and papaverine. A histopathological study showed a protective effect against necrosis and apoptosis (p<0.05) in the NM group.

CONCLUSION

NM exhibited good vascular relaxation and a reasonable anti-vasocontraction effect with a better cell protecting effect than papaverine; therefore, we concluded that NM is a good potential conduit preserving agent.

摘要

背景

冠状动脉搭桥手术中使用的移植物血管保存溶液用于在围手术期将移植物血管维持在最佳状态。甲磺酸萘莫司他（NM）具有抗凝和抗炎特性。因此，我们研究了NM作为血管保存剂，并将其与罂粟碱进行比较。

方法

在标准经典器官浴中用罂粟碱和NM预孵育后，使用去氧肾上腺素（PE）和乙酰胆碱（ACh）检测Sprague-Dawley（SD）大鼠胸主动脉的收缩-舒张能力。培养人脐静脉内皮细胞（HUVECs）以检查内皮细胞活力。对SD大鼠的胸主动脉进行组织病理学检查和末端脱氧核苷酸转移酶dUTP缺口末端标记分析。

结果

在PE作用下，罂粟碱的抗收缩作用优于NM（p<0.05）。NM对ACh诱导的血管舒张的松弛作用与罂粟碱无统计学差异。使用HUVECs的活力测定显示，在NM和罂粟碱的各种浓度下，内皮细胞存活率均>90%。组织病理学研究显示，NM组对坏死和凋亡具有保护作用（p<0.05）。

结论

NM表现出良好的血管舒张和合理的抗血管收缩作用，且细胞保护作用优于罂粟碱；因此，我们得出结论，NM是一种良好的潜在血管保存剂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/a8642d1afa05/kjtcs-46-413-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/aa0957697791/kjtcs-46-413-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/80a6d67d4358/kjtcs-46-413-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/f6d02766e0e1/kjtcs-46-413-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/b074c4136fe3/kjtcs-46-413-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/aadcdbaed008/kjtcs-46-413-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/085facc8dfb0/kjtcs-46-413-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/acf5f9621511/kjtcs-46-413-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/a8642d1afa05/kjtcs-46-413-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/aa0957697791/kjtcs-46-413-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/80a6d67d4358/kjtcs-46-413-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/f6d02766e0e1/kjtcs-46-413-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/b074c4136fe3/kjtcs-46-413-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/aadcdbaed008/kjtcs-46-413-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/085facc8dfb0/kjtcs-46-413-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/acf5f9621511/kjtcs-46-413-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af4/3868688/a8642d1afa05/kjtcs-46-413-g008.jpg

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