Nafamostat mesilate: can it be used as a conduit preserving agent in coronary artery bypass surgery?
Nafamostat mesilate: can it be used as a conduit preserving agent in coronary artery bypass surgery?
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DOI：
10.5090/kjtcs.2013.46.6.413
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发表时间：
2013-12
期刊：
影响因子：
--
通讯作者：
Kang MW
中科院分区：
文献类型：
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作者：
Yoon YS;Oh H;Kim Y;Lim SP;Kim CS;Kang MW
冠状动脉搭桥术中使用移植物血管保存液维持移植导管在围手术期处于最佳状态。甲磺酸纳莫他酯（NM）具有抗凝和抗炎作用。因此，我们研究了NM作为导管防腐剂，并将其与罂粟碱进行了比较。在标准的经典器官浴中，用罂粟碱和NM预孵育后，用苯肾上腺素（PE）和乙酰胆碱（ACh）检测SD大鼠胸主动脉的收缩舒张能力。培养人脐静脉内皮细胞（HUVECs），检测内皮细胞活力。对SD大鼠胸主动脉进行组织病理学检查和末端脱氧核苷酸转移酶dUTP缺口末端标记试验。在PE时，罂粟碱的抗收缩作用优于NM （p<0.05）。NM对乙酰胆碱诱导的血管舒张的松弛作用与罂粟碱的松弛作用无统计学差异。利用HUVECs进行的活力测定显示，在不同浓度的NM和罂粟碱中，内皮细胞的存活率为10 - 90%。组织病理学研究显示，NM组对坏死和细胞凋亡有保护作用（p<0.05）。NM具有良好的血管舒张作用和合理的抗血管收缩作用，其细胞保护作用优于罂粟碱；因此，我们认为NM是一种很有潜力的导管保存剂。
Graft vessel preservation solution in coronary artery bypass surgery is used to maintain the graft conduit in optimal condition during the perioperative period. Nafamostat mesilate (NM) has anticoagulation and anti-inflammatory properties. Therefore, we investigated NM as a conduit preservative agent and compared it to papaverine. Sprague-Dawley (SD) rat thoracic aortas were examined for their contraction-relaxation ability using phenylephrine (PE) and acetylcholine (ACh) following preincubation with papaverine and NM in standard classical organ baths. Human umbilical vein endothelial cells (HUVECs) were cultured to check for the endothelial cell viability. Histopathological examination and terminal deoxynucleotidyl transferase dUTP nick end labeling assay were performed on the thoracic aortas of SD rats. The anti-contraction effects of papaverine were superior to those of NM at PE (p<0.05). The relaxation effect of NM on ACh-induced vasodilatation was not statistically different from that of papaverine. Viability assays using HUVECs showed endothelial cell survival rates of >90% in various concentrations of both NM and papaverine. A histopathological study showed a protective effect against necrosis and apoptosis (p<0.05) in the NM group. NM exhibited good vascular relaxation and a reasonable anti-vasocontraction effect with a better cell protecting effect than papaverine; therefore, we concluded that NM is a good potential conduit preserving agent.