Cohen J R, Perry M O, Hariri R, Holt J, Alvarez O
J Vasc Surg. 1984 Jul;1(4):562-5.
Recent biochemical evidence that aneurysm formation may be related to higher activated collagenase levels within aneurysmal aortic walls in association with reports of asymptomatic aneurysm rupture after laparotomy has led to speculation that operative trauma unrelated to direct aortic injury may increase the chance of aneurysm rupture by inducing collagenase activation within the aortic wall. The purpose of this study was to determine whether aortic collagenase can be activated by distant operative trauma and the kinetics of activation after injury. Ninety-six rats were divided into four groups: group 1--laparotomy alone; group 2--cecal resection; group 3--aortic mobilization; and group 4--aortotomy and repair. Animals within each group were sacrificed 1,3, and 6 hours and 1,2,3,4, and 5 days after surgery. The abdominal aortas were removed and assayed for collagenase activity by incubation with and digestion of tritium-labeled collagen. Collagenase activity was significantly elevated up to 6 hours after direct aortic injury (p less than 0.05) and decreased to normal levels within 2 days. Laparotomy, colon resection, and aortic mobilization had no significant effect on aortic collagenase activity compared to the controls. These data suggest that collagenase activity is a local phenomenon related to wound healing at the site of initial injury. Operative trauma without direct aortic injury had no effect on aortic collagenase activity.
最近有生物化学证据表明，动脉瘤形成可能与动脉瘤性主动脉壁内较高的活化胶原酶水平有关，同时有关于剖腹手术后无症状动脉瘤破裂的报道，这引发了一种推测，即与直接主动脉损伤无关的手术创伤可能通过诱导主动脉壁内胶原酶活化而增加动脉瘤破裂的几率。本研究的目的是确定主动脉胶原酶是否可被远处的手术创伤激活以及损伤后激活的动力学。96只大鼠被分为四组：第1组——仅行剖腹手术；第2组——盲肠切除术；第3组——主动脉游离术；第4组——主动脉切开修复术。每组动物在术后1、3和6小时以及1、2、3、4和5天处死。取出腹主动脉，通过与氚标记的胶原孵育并消化来检测胶原酶活性。直接主动脉损伤后6小时内胶原酶活性显著升高（p<0.05），并在2天内降至正常水平。与对照组相比，剖腹手术、结肠切除术和主动脉游离术对主动脉胶原酶活性无显著影响。这些数据表明，胶原酶活性是一种与初始损伤部位伤口愈合相关的局部现象。无直接主动脉损伤的手术创伤对主动脉胶原酶活性无影响。
