Oyama K, Ohnuki T, Ohnuki N, Nitta S
Department of Surgery I, Tokyo Women's Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Nov;44(11):2032-9.
We examined local effects of basic fibroblast growth factor (bFGF) on early bronchial revascularization following bronchial anastomosis. The left main bronchi of mongrel dogs (8-15 kg) were cut and sutured following peripheral radical hilar stripping. The anastomotic sites were wrapped with a pericardial fat tissue pedicle, including branches of the internal thoracic artery and vein (8 dogs group A). One ml of bFGF (Biomedical Tecnologies Inc.) dissolved in 1 ml of fibrin glue (final concentration of 20 ng/ml for a total dose of 100 ng, pH 7.15-7.5) was applied to the anastomotic sites in order to deliver the bFGF gradually and selectively (12 dogs group B). At various timepoints, changes in bronchial mucosal blood flow were measured using a laser Doppler flowmeter and left internal thoracic artery (LITA) blood flow, using an implanted electromagnetic flowmeter. On the 7th postoperative day, silicone rubber was injected into the left subclavian artery, and the revascularization pattern from branches of the LITA to the bronchus was examined histologically. Specimens were labeled as (-) when the neogenic vessels were only observed outside the bronchial wall, (1+) when observed inside the bronchial wall but not in the mucosa, and (2+) when clearly observed in the mucosa. Blood flow in the bronchial mucosa was measured as the left/right ratio. For group A, the averages immediately after operation, and on the 3rd and on the 7th postoperative days, were 0.35 +/- 0.10, 0.46 +/- 0.04, and 0.70 +/- 0.14 respectively; while, for group B, they were 0.27 +/- 0.09, 0.78 +/- 0.15, and 0.90 +/- 0.15, respectively (p < 0.01). Our results show that blood flow in the LITA increased more in group B than in group A (average 2.7 +/- 1.8 ml/min in group A, vs. 4.7 +/- 2.9 ml/min in group B). Furthermore, the pathologic findings of neovascularization were (-) in 3 cases and (1+) in 2 cases in group A, while group B showed (1+) neovascularization in 1 case and (2+) in 4 cases. These results clearly demonstrate increased revascularization in the bFGF treatment group B. We conclude that local application of bFGF is effective in stimulating early bronchial revascularization.
我们研究了碱性成纤维细胞生长因子（bFGF）对支气管吻合术后早期支气管血管再生的局部影响。对杂种犬（8 - 15千克）的左主支气管进行外周根治性肺门剥离后切断并缝合。吻合部位用带蒂的心包脂肪组织包裹，包括胸廓内动静脉分支（8只犬，A组）。将1毫升溶解于1毫升纤维蛋白胶中的bFGF（生物医学技术公司）（最终浓度为20纳克/毫升，总剂量100纳克，pH 7.15 - 7.5）应用于吻合部位，以便逐渐且有选择地递送bFGF（12只犬，B组）。在不同时间点，使用激光多普勒血流仪测量支气管黏膜血流变化，使用植入式电磁血流仪测量左胸廓内动脉（LITA）血流。术后第7天，向左锁骨下动脉注射硅橡胶，组织学检查LITA分支至支气管的血管再生模式。当新生血管仅在支气管壁外观察到时，标本标记为（-）；当在支气管壁内但不在黏膜中观察到时，标记为（1 +）；当在黏膜中清晰观察到时，标记为（2 +）。支气管黏膜血流以左/右比值测量。A组术后即刻、术后第3天和第7天的平均值分别为0.35±0.10、0.46±0.04和0.70±0.14；而B组分别为0.27±0.09、0.78±0.15和0.90±0.15（p < 0.01）。我们的结果表明，B组LITA中的血流增加幅度大于A组（A组平均为2.7±1.8毫升/分钟，B组为4.7±2.9毫升/分钟）。此外，A组新生血管化的病理结果为3例（-）、2例（1 +），而B组显示1例（1 +）、4例（2 +）。这些结果清楚地表明B组bFGF治疗组的血管再生增加。我们得出结论，局部应用bFGF可有效刺激早期支气管血管再生。
