Endean E D, Boorstein J M, Hees P L, Cronenwett J L
J Surg Res. 1986 Apr;40(4):297-304. doi: 10.1016/0022-4804(86)90190-3.
This study examined the effect of an orally active thromboxane (TXA2) synthetase inhibitor (TSI) on the patency, TXA2 production, and platelet accumulation of reversed autogenous vein grafts. Ten dogs received TSI (U-63557A) 10 mg/kg po q8 hr for 6 weeks, beginning 24 hr prior to surgery, while 15 control dogs were untreated. One jugular vein was harvested and stored in 37 degrees C saline for 1 hr to induce mild endothelial injury (stored). Normal and stored jugular vein grafts (8 cm) were then implanted in opposite femoral arteries while 3-cm segments of the same veins were implanted in the carotid arteries. Femoral graft flow was restricted with a 5 Fr distal arterial stenosis and patency determined by arteriography at 1, 2, 4, and 6 weeks. Vein graft endothelial surface TXB2 production was measured by RIA at graft implantation and in carotid grafts harvested at 1 week. 111In-labeled platelets were given iv 24 hr prior to carotid graft harvest to determine graft-platelet deposition. TSI treatment improved early (1 week) femoral vein graft patency from 63 to 89% (P less than 0.05), a trend that persisted for 6 weeks. Warm saline storage reduced 1-week graft patency from 83 to 63% (P less than 0.05), a difference that decreased with time. TSI treatment resulted in a marked decrease in TXB2 production, but was not associated with decreased 111In-labeled platelet deposition in carotid vein grafts. Warm saline storage increased graft-platelet deposition which was predominant at the arterial anastomoses. TSI treatment may improve early vein graft patency during the transient period of endothelial injury.
本研究检测了一种口服活性血栓素（TXA2）合成酶抑制剂（TSI）对自体静脉移植血管通畅率、TXA2生成及血小板聚集的影响。10只犬在手术前24小时开始接受TSI（U - 63557A），剂量为10mg/kg，口服，每8小时一次，持续6周，而15只对照犬未接受治疗。采集一条颈静脉并置于37℃盐水中1小时以诱导轻度内皮损伤（储存）。然后将正常和储存的颈静脉移植血管（8cm）分别植入对侧股动脉，同时将同一段静脉的3cm节段植入颈动脉。用5Fr远端动脉狭窄限制股动脉移植血管血流，并在第1、2、4和6周通过血管造影术确定通畅率。在移植血管植入时以及在第1周采集的颈动脉移植血管中，通过放射免疫分析法测量静脉移植血管内皮表面TXB2的生成。在采集颈动脉移植血管前24小时静脉注射111In标记的血小板，以确定移植血管内血小板沉积情况。TSI治疗使早期（1周）股静脉移植血管通畅率从63%提高到89%（P<0.05），这一趋势持续了6周。温盐水储存使1周移植血管通畅率从83%降至63%（P<0.05），这种差异随时间减小。TSI治疗导致TXB2生成显著减少，但与颈动脉静脉移植血管中111In标记的血小板沉积减少无关。温盐水储存增加了移植血管内血小板沉积，这种沉积在动脉吻合处最为明显。TSI治疗可能在内皮损伤的短暂时期改善早期静脉移植血管通畅率。
