Page 64 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第41卷第11期
·1626 · Journal of Nanjing Medical University（Natural Sciences） 2021年11月

·临床研究·

冠状动脉旁路移植术动脉移植物旋股外动脉降支与乳内动脉

血管功能的比较

沈晓炜，李 奔，季宇萌，王旭枫，徐骁晗，陆小虎，王晓伟 *

南京医科大学第一附属医院心脏大血管外科，江苏 南京 210029

［摘 要］ 目的：比较冠状动脉旁路移植术动脉移植物旋股外动脉降支（descending branch of lateral circumflex femoral artery，
DBLCFA）与乳内动脉（internal mammary artery，IMA）的血管功能，根据二者对血管收缩剂和舒张剂的药理学反应评估其痉挛
特征及内皮功能。方法：将20例冠状动脉搭桥患者的33支DBLCFA血管环和31支IMA血管环平衡于器官浴中。血管收缩性
由受体介导的血管收缩剂内皮素⁃1、血管紧张素Ⅱ和血栓素A2模拟物U46619检测。乙酰胆碱用于测试内皮依赖性舒张，硝
酸甘油用于测试非内皮依赖性舒张。比较两种动脉的最大收缩或舒张反应，以及引起 50 %最大收缩或舒张反应的有效浓
度。结果：内皮素⁃1、血管紧张素Ⅱ和 U46619 引起的收缩中，DBLCFA 的反应性均高于乳内动脉，分别为［（0.94±0.09）g vs.
（0.57±0.08）g，P=0.012］、［（0.88±0.13）g vs.（0.24±0.05）g，P < 0.001］、［（4.95±0.57）g vs.（1.86±0.30）g，P=0.001］。转换成由
100 mmol/L KCl引起的收缩力百分比时，两者无明显差异。由内皮素⁃1和血管紧张素Ⅱ引起的50 %最大收缩反应的有效浓度
无明显差异。由U46619引起的50 %最大收缩反应有效浓度，DBLCFA高于IMA。受体介导的内皮依赖性舒张和非内皮依赖
性舒张在两种血管间无明显差异。两种动脉引起50 %最大舒张反应的有效浓度无明显差异。结论：DBLCFA对血管收缩剂的
药理学反应高于IMA，提示其更易发生血管痉挛。DBLCFA舒张反应与IMA相似，但DBLCFA更易痉挛，因而其血管功能次于
IMA。但当IMA使用受限时，DBLCFA可作为一种选择。
［关键词］ 旋股外动脉降支；乳内动脉；反应性

［中图分类号］ R654.3 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）11⁃1626⁃06
doi：10.7655/NYDXBNS20211110

Comparison of the vascular function of the descending branch of the external circumflex
femoral artery and the internal mammary artery in coronary artery bypass grafting

*
SHEN Xiaowei，LI Ben，JI Yumeng，WANG Xufeng，XU Xiaohan，LU Xiaohu，WANG Xiaowei
Department of Cardiovascular Surgery，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，
China

［Abstract］ Objective：This study aims to compare the vascular function of the descending branch of lateral circumflex femoral artery
（DBLCFA）and the internal mammary artery（IMA）of coronary artery bypass grafts，according to the vasoconstrictor and diastolic
effects of the two drug pharmacological response to evaluate its spasticity characteristics and endothelial function. Methods：The 33
descending branches of the external circumflex femoral artery and 31 internal mammary arteries of 20 patients with coronary artery
bypass grafting were balanced in the organ bath. Vasoconstriction was detected by receptor⁃mediated vasoconstrictors endothelin⁃ 1，
angiotensin Ⅱ and thromboxane A2 mimic U46619. Acetylcholine was used to test endothelium ⁃ dependent relaxation，and
nitroglycerin was used to test endothelium⁃independent relaxation. The maximum contraction or relaxation response of the two arteries，
and the effective concentration that caused 50% of the maximum contraction or relaxation response were compared. Results：In the
contraction caused by endothelin⁃1，angiotensin Ⅱ and U46619，the reactivity of DBLCFA was higher than that of IMA，respectively
［（0.94±0.09）g vs.（0.57±0.08）g，P=0.012；（0.88±0.13）g vs.（0.24±0.05）g，P < 0.001；（4.95±0.57）g vs.（1.86±0.30）g，P=0.001］.
When converted into the percentage of contractile force caused by 100 mmol/L KCl，there was no significant difference between the two

［基金项目］ 江苏省卫生健康委医学科研项目（ZDA2020004）
∗
通信作者（Corresponding author），E⁃mail：wangxiaowei@njmu.edu.cn