Local administration of nitric oxide donor significantly impacts microvascular thrombosis
Local administration of nitric oxide donor significantly impacts microvascular thrombosis
复制标题
DOI：
10.1097/00005537-200303000-00003
复制
发表时间：
2003-03-01
期刊：
影响因子：
2.6
通讯作者：
Blackwell, K
中科院分区：
文献类型：
--
作者：
Chiang, S;Azizzadeh, B;Blackwell, K
目的/假设：在实验和临床环境中，临床药物治疗在预防微血管血栓形成中已显示出作用。先前在兔模型中的研究已经注意到静脉输注一氧化氮拮抗剂会增加血栓形成率。该研究评估了局部应用一氧化氮激动剂和拮抗剂对微血管吻合口通畅率的影响。研究设计：随机、前瞻性分析。方法.在新西兰白色兔中使用动脉倒置移植物微血管血栓形成模型。将家兔随机分为一氧化氮激动剂组、拮抗剂组和对照组。在每只家兔中，通过手术暴露股总动脉，并收获2 mm动脉倒置移植物。在100 mumol/L精胺NONOate（一氧化氮供体）、100 mumol/L硝基-L-精氨酸甲酯（L-NAME）（一氧化氮合酶抑制剂）或0.09%氯化钠（对照）溶液中进行移植物与股总动脉的吻合。对侧股总动脉也使用相同的溶液进行了动脉内翻移植物试验。吻合后1小时评估动脉通畅性。结果：在精胺NONOate溶液中进行的22例动脉内翻移植物中有16例保持通畅，6例发生凝血。在对照溶液中进行的21例动脉倒置移植物中，11例保持通畅，10例凝血。在L-NAME溶液中进行的21例动脉内翻移植物中有7例保持通畅，14例凝血。使用x（2）检验发现这些结果具有统计学显著性，P值小于0.05。结论.在兔模型中，局部应用一氧化氮激动剂和拮抗剂可显著影响吻合口通畅率。进一步的研究可能会证明一氧化氮在微血管手术中的临床应用的作用。
Objectives/Hypothesis: Clinical pharmacotherapy has demonstrated a role in preventing microvascular thrombosis in both experimental and clinical settings. Previous studies in the rabbit model have noted an increased rate of thrombosis with intravenous infusion of nitric oxide antagonists. The study assessed the effects of local application of nitric oxide agonists and antagonists on microvascular anastomotic patency rates. Study Design: A randomized, prospective analysis. Methods. An arterial inversion graft microvascular thrombosis model was used in New Zealand white rabbits. The rabbits were randomly assigned to nitric oxide agonist, antagonist, and control groups. In each rabbit, the common femoral artery was surgically exposed and a 2-mm arterial inversion graft was harvested. The anastomosis of the graft to the common femoral artery was performed in solutions of either 100 mumol/L spermine NONOate (nitric oxide donor), 100 mumol/L nitro-L-arginine-methyl ester (L-NAME) (nitric oxide synthase inhibitor), or 0.09% sodium chloride (control) solution. The contralateral common femoral artery also underwent arterial inversion graft testing with the use of the same solution. Arterial patency was assessed I hour after anastomosis. Results: Sixteen of 22 arterial inversion grafts performed in the spermine NONOate solution remained patent, and 6 of 22 clotted. Eleven of 21 arterial inversion grafts performed in the control solution remained patent, and 10 clotted. Seven of 21 arterial inversion grafts performed in the L-NAME solution remained patent, and 14 clotted. These results were found to be statistically significant using the x(2) test with a P value of less than .05. Conclusions. In the rabbit model, local application of nitric oxide agonists and antagonists can significantly impact anastomotic patency rates. Further studies may demonstrate a role for the clinical use of nitric oxide in microvascular surgery.