Chaikhouni A, Crawford F A, Kochel P J, Olanoff L S, Halushka P V
J Thorac Cardiovasc Surg. 1986 Jul;92(1):88-91.
The patency rate of internal mammary artery grafts is reported to be better than that of saphenous vein grafts in myocardial revascularization operations. To identify a possible biochemical explanation for this phenomenon, we studied the production of prostacyclin by the internal mammary artery and saphenous vein in 11 patients. Segments of internal mammary artery and saphenous vein from each patient were incubated in Krebs-Henseleit buffer at 37 degrees C. After 15 minutes, the basal production of 6-keto-prostaglandin F1 alpha (prostacyclin metabolite) by the internal mammary artery was 152 +/- 39 pg/mg wet weight (mean +/- standard error of the mean), whereas the saphenous vein produced only 68 +/- 17 pg/mg (p less than 0.001). After 30 minutes, the internal mammary artery produced 179 +/- 42 pg/mg, whereas the saphenous vein produced 75 +/- 18 pg/mg (p less than 0.001). After the basal incubation period, the vessels were incubated with arachidonic acid (prostaglandin substrate) for 15 minutes. The internal mammary artery produced 49.4 +/- 9.9 pg/mg, whereas the saphenous vein produced only 22.6 +/- 9.8 pg/mg (p less than 0.01). These observations suggest that the capacity of the internal mammary artery to produce prostacyclin in both a basal and a stimulated state is greater than that of the saphenous vein. Since prostacyclin is a potent vasodilator and inhibitor of platelet function, these results provide a possible biochemical explanation for the clinically observed better patency rate of internal mammary artery grafts.
据报道,在心肌血运重建手术中,乳内动脉移植物的通畅率优于大隐静脉移植物。为了找出这一现象可能的生化解释,我们研究了11例患者的乳内动脉和大隐静脉中前列环素的生成情况。将每位患者的乳内动脉和大隐静脉段在37℃的克雷布斯 - 亨泽莱特缓冲液中孵育。15分钟后,乳内动脉6 - 酮 - 前列腺素F1α(前列环素代谢物)的基础生成量为152±39 pg/mg湿重(平均值±平均标准误差),而大隐静脉仅产生68±17 pg/mg(p<0.001)。30分钟后,乳内动脉产生179±42 pg/mg,而大隐静脉产生75±18 pg/mg(p<0.001)。在基础孵育期后,将血管与花生四烯酸(前列腺素底物)孵育15分钟。乳内动脉产生49.4±9.9 pg/mg,而大隐静脉仅产生22.6±9.8 pg/mg(p<0.01)。这些观察结果表明,乳内动脉在基础状态和刺激状态下产生前列环素的能力均大于大隐静脉。由于前列环素是一种强效血管扩张剂和血小板功能抑制剂,这些结果为临床上观察到的乳内动脉移植物更好的通畅率提供了一种可能的生化解释。