Mersin City Training and Research Hospital Department of Cardiovascular Surgery Mersin Turkey Department of Cardiovascular Surgery, Mersin City Training and Research Hospital, Mersin, Turkey.
Mersin University Vocational School Department of Medical Services and Techniques Mersin Turkey Department of Medical Services and Techniques of Vocational School, Mersin University, Mersin, Turkey.
Braz J Cardiovasc Surg. 2020 Oct 1;35(5):675-682. doi: 10.21470/1678-9741-2019-0470.
To elucidate the effect of diabetes mellitus (DM) on the atherosclerotic process in saphenous vein grafts by determining urotensin-II (U-II) levels in harvested saphenous veins of patients who underwent coronary artery bypass grafting (CABG).
Coronary artery disease (CAD) patients who underwent CABG were divided into two groups: Group I (eight non-diabetic patients; CAD group) and Group II (13 patients; DM+CAD group). All patients underwent coronary angiography prior to surgery and Gensini score was used to determine the severity of coronary atherosclerosis. Saphenous vein samples were stained with hematoxylin-eosin and U-II, then damage score, H-Score, and vein layer thicknesses were calculated and statistically evaluated.
In light microscopic evaluation, significant difference was observed between the groups in terms of endothelial cells damage, internal elastic lamina degradation, and tunica media vascular smooth muscle cells (VSMCs) damage (P<0.001). U-II immunoreactivity was increased in tunica adventitia in the DM+CAD group (P=0.002). The increase in foam cells was directly proportional to the thickening of the subendothelial layer, and this increased U-II immunoreactivity. Gensini score was higher in the DM+CAD group than in the CAD group (P=0.002).
Our results show that saphenous vein grafts are already atherosclerotic before they are grafted in CAD patients. This disease is more severe in diabetic CAD patients and these changes can be detected using U-II immunoreactivity.
通过测定行冠状动脉旁路移植术（CABG）患者所取大隐静脉中的尾加压素 II（U-II）水平，阐明糖尿病（DM）对大隐静脉移植物动脉粥样硬化进程的影响。
将行 CABG 的冠心病（CAD）患者分为两组：I 组（8 例非糖尿病患者；CAD 组）和 II 组（13 例糖尿病+CAD 组）。所有患者术前均行冠状动脉造影，采用 Gensini 评分来确定冠状动脉粥样硬化的严重程度。对大隐静脉样本进行苏木精-伊红染色和 U-II 染色，然后计算并对损伤评分、H 评分和静脉层厚度进行统计学评估。
在光镜评估中，两组在内皮细胞损伤、内弹性膜降解和血管中层平滑肌细胞（VSMCs）损伤方面存在显著差异（P<0.001）。在 DM+CAD 组中，U-II 免疫反应性在血管外膜中增加（P=0.002）。泡沫细胞的增加与内皮下层的增厚成正比，且这种增加与 U-II 免疫反应性成正比。DM+CAD 组的 Gensini 评分高于 CAD 组（P=0.002）。
我们的结果表明，在 CAD 患者中，大隐静脉移植物在移植前就已经发生了动脉粥样硬化。在糖尿病合并 CAD 患者中，这种疾病更为严重，并且可以通过 U-II 免疫反应性检测到这些变化。
