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动脉肝素沉积:扩散、对流及血管外间隙的作用

Arterial heparin deposition: role of diffusion, convection, and extravascular space.

作者信息

Lovich M A, Philbrook M, Sawyer S, Weselcouch E, Edelman E R

机构信息

Division of Health Sciences and Technology, Harvard University-Massachusetts Institute of Technology, Cambridge 02139, Massachusetts, USA.

出版信息

Am J Physiol. 1998 Dec;275(6):H2236-42. doi: 10.1152/ajpheart.1998.275.6.H2236.

Abstract

Transvascular transport has been studied with atherogenic, tracer, and inert compounds such as low-density lipoprotein, horseradish peroxidase, and albumin, respectively. Few studies used vasoactive compounds, and virtually all studies examined entry from the lumen and not from the perivascular space. We compared several mechanisms that govern arterial heparin deposition after administration to the perivascular and endovascular aspects of the calf carotid artery in vitro and the rabbit iliac artery in vivo. In the absence of transmural hydrostatic pressure gradients, heparin deposition following endovascular administration was unaffected by deendothelialization and was indistinguishable from perivascular delivery. Deposition in the former was enhanced by the addition of a pressure gradient and to a greater extent in denuded arteries, indicating that convection influences transport but is dampened by the endothelium. Neither the endothelium nor the adventitia pose significant resistances to heparin. Deposition in vivo was greater following endovascular hydrogel release than perivascular application from similar devices to native or denuded arteries. The loss of drug to extra-arterial microvessels exceeded the loss of drug to the lumen flow. These findings are essential for describing vascular pharmacokinetics and for implementing local pharmacotherapies.

摘要

已分别使用致动脉粥样硬化化合物、示踪剂和惰性化合物(如低密度脂蛋白、辣根过氧化物酶和白蛋白)对跨血管运输进行了研究。很少有研究使用血管活性化合物,而且几乎所有研究都考察的是药物从管腔进入,而非从血管周围间隙进入。我们比较了在体外对小牛颈动脉的血管周围和血管内部分以及在体内对兔髂动脉给药后,几种控制动脉肝素沉积的机制。在不存在跨壁静水压力梯度的情况下,血管内给药后的肝素沉积不受去内皮化影响,且与血管周围给药无差异。通过施加压力梯度可增强前者中的沉积,在剥脱内皮的动脉中增强程度更大,这表明对流影响运输,但会被内皮抑制。内皮和外膜对肝素均无显著阻力。与从类似装置向天然或剥脱内皮的动脉进行血管周围给药相比,血管内水凝胶释放后在体内的沉积更多。药物向动脉外微血管的损失超过了向管腔血流的损失。这些发现对于描述血管药代动力学和实施局部药物治疗至关重要。

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