罂粟碱在冠状动脉旁路移植术（CABG）手术桡动脉预扩张中对血管舒张的疗效及对内皮的影响：寻找最佳浓度

Vasodilatory Efficacy and Impact of Papaverine on Endothelium in Radial Artery Predilatation for CABG Surgery: in Search for Optimal Concentration.

作者信息

Węgrzyn Piotr, Lis Grzegorz, Rudzinski Paweł, Piatek Jacek, Pyka-Fosciak Grazyna, Korbut Ryszard, Kapelak Boguslaw, Bartus Krzysztof, Litwinowicz Radoslaw

机构信息

Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Jagiellonian University Medical College, Krakow, Poland.

Department of Histology, Jagiellonian University Medical College, Krakow, Poland.

出版信息

Braz J Cardiovasc Surg. 2018 Nov-Dec;33(6):553-558. doi: 10.21470/1678-9741-2018-0139.

DOI:10.21470/1678-9741-2018-0139

PMID:30652743

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6326436/

Abstract

OBJECTIVE

The aim of this study was to compare the efficacy of two different papaverine concentrations (0.5 mg/ml and 2 mg/ml) for vasospasm prevention and their impact on endothelium integrity.

METHODS

We have studied distal segments of radial arteries obtained by no-touch technique from coronary artery bypass graft (CABG) patients (n=10). The vasodilatory effect of papaverine (concentrations of 0.5 mg/ml and 2 mg/ml) was assessed in vitro, in isometric tension studies using ex vivo myography (organ bath technique) and arterial rings precontracted with potassium chloride (KCl) and phenylephrine. The impact of papaverine on endothelial integrity was studied by measurement of the percentage of vessel's circumference revealing CD34 endothelial marker.

RESULTS

2 mg/ml papaverine concentration showed stronger vasodilatatory effect than 0.5 mg/ml, but it caused significantly higher endothelial damage. Response to KCl was 7.35±3.33 mN for vessels protected with papaverine 0.5 mg/ml and 2.66±1.96 mN when papaverine in concentration of 2 mg/ml was used. The histological examination revealed a significant difference in the presence of undamaged endothelium between vessels incubated in papaverine 0.5 mg/ml (72.86±9.3%) and 2 mg/ml (50.23±13.42%), P=0.002.

CONCLUSION

Papaverine 2 mg/ml caused the higher endothelial damage. Concentration of 0.5 mg/ml caused better preservation of the endothelial lining.

摘要

目的

本研究旨在比较两种不同浓度罂粟碱（0.5毫克/毫升和2毫克/毫升）预防血管痉挛的疗效及其对内皮完整性的影响。

方法

我们研究了通过非接触技术从冠状动脉搭桥术（CABG）患者（n = 10）获取的桡动脉远端节段。在体外，使用离体肌动描记法（器官浴技术）和用氯化钾（KCl）和去氧肾上腺素预收缩的动脉环，通过等长张力研究评估罂粟碱（浓度为0.5毫克/毫升和2毫克/毫升）的血管舒张作用。通过测量显示CD34内皮标志物的血管周长百分比来研究罂粟碱对内皮完整性的影响。

结果

2毫克/毫升罂粟碱浓度显示出比0.5毫克/毫升更强的血管舒张作用，但它导致的内皮损伤明显更高。用0.5毫克/毫升罂粟碱保护的血管对KCl的反应为7.35±3.33毫牛顿，而使用2毫克/毫升浓度的罂粟碱时为2.66±1.96毫牛顿。组织学检查显示，在0.5毫克/毫升（72.86±9.3%）和2毫克/毫升（50.23±13.42%）罂粟碱中孵育的血管之间，未受损内皮的存在有显著差异，P = 0.002。