Kobinia G S, LaRaia P J, D'Ambra M N, Fabri B M, Aylesworth C A, Peterson M B, Watkins W D, Buckley M J
J Thorac Cardiovasc Surg. 1986 Jun;91(6):852-7.
Systemic and cardiac metabolism of thromboxane was studied in a canine model (n = 13) of standard cardiopulmonary bypass and surgical cardioplegia. Sterile techniques were applied and no donor blood was used. Systemic samples (thoracic aorta) and transcardiac gradients (coronary sinus - aortic root) were obtained (1) 5 minutes after cannulation, (2) 20 minutes after the onset of partial bypass, (3) 5 seconds after the first administration of cardioplegic solution (CP-1), and (4) 5 seconds after the second administration of cardioplegic solution (CP-2). Cardioplegic doses were administered 30 minutes apart and consisted of 500 ml of hypothermic (8 degrees C), hyperkalemic (25 mEq potassium chloride) solution infused into the aortic root at 60 to 70 mm Hg. Thromboxane B2 was determined by a double-antibody radioimmunoassay (picograms per milliliter +/- standard error of the mean). Onset of partial bypass was followed by a significant rise in systemic arterial thromboxane B2 levels: after cannulation, 115 +/- 21 pg/ml; after the onset of partial bypass, 596 +/- 141 pg/ml; p less than 0.01). Significant transcardiac thromboxane B2 gradients were found during the first and second cardioplegic washouts (CP-1: aortic root 73 +/- 12 pg/ml, coronary sinus 306 +/- 86 pg/ml, p less than 0.01; CP-2: aortic root 65 +/- 11 pg/ml, coronary sinus 355 +/- 98 pg/ml, p less than 0.01). Transcardiac gradients of 6-keto-prostaglandin F1 alpha and thromboxane B2 were obtained at CP-1 and CP-2. Gradients of 6-keto-prostaglandin F1 alpha were not different from thromboxane B2 gradients during CP-1 but were significantly higher than thromboxane B2 gradients during CP-2. In a subgroup of five dogs, transcardiac thromboxane B2, lactate, and platelet gradients were measured simultaneously. Cardiac thromboxane B2 generation was found only in the presence of cardiac lactate production. Transcardiac platelet gradients were significantly higher at CP-1 (13,900 +/- 3,000/mm3) than at CP-2 (4,000 +/- 1,230/mm3) (p less than 0.05), whereas thromboxane B2 gradients were similar at CP-1 and CP-2. Our study demonstrates that thromboxane B2 is released into the coronary circulation during surgical cardioplegic arrest with anaerobiosis.
在标准体外循环和手术心脏停搏的犬模型（n = 13）中研究了血栓素的全身代谢和心脏代谢。采用无菌技术，未使用供血。在以下时间点获取全身样本（胸主动脉）和心脏跨壁梯度（冠状窦 - 主动脉根部）：（1）插管后5分钟；（2）部分体外循环开始后20分钟；（3）首次给予心脏停搏液（CP - 1）后5秒；（4）第二次给予心脏停搏液（CP - 2）后5秒。心脏停搏液剂量间隔30分钟给予，由500 ml低温（8℃）、高钾（25 mEq氯化钾）溶液以60至70 mmHg的压力注入主动脉根部。采用双抗体放射免疫分析法测定血栓素B2（皮克/毫升±平均标准误差）。部分体外循环开始后，全身动脉血栓素B2水平显著升高：插管后为115±21 pg/ml；部分体外循环开始后为596±141 pg/ml；p<0.01）。在首次和第二次心脏停搏液冲洗期间发现显著的心脏跨壁血栓素B2梯度（CP - 1：主动脉根部73±12 pg/ml，冠状窦306±86 pg/ml，p<0.01；CP - 2：主动脉根部65±11 pg/ml，冠状窦355±98 pg/ml，p<0.01）。在CP - 1和CP - 2时获取6 - 酮 - 前列腺素F1α和血栓素B2的心脏跨壁梯度。在CP - 1期间，6 - 酮 - 前列腺素F1α梯度与血栓素B2梯度无差异，但在CP - 2期间显著高于血栓素B2梯度。在一组5只犬的亚组中，同时测量心脏跨壁血栓素B2、乳酸和血小板梯度。仅在存在心脏乳酸产生时才发现心脏血栓素B2生成。CP - 1时心脏跨壁血小板梯度（13,900±3,000/mm3）显著高于CP - 2时（4,000±1,230/mm3）（p<0.05），而CP - 1和CP - 2时血栓素B2梯度相似。我们的研究表明，在手术心脏停搏合并无氧代谢期间，血栓素B2释放到冠状动脉循环中。
