Adhesion Molecules and Stress with Cardiac Surgery

心脏手术中的粘附分子和应力

• 批准号: 13671412
• 负责人: OKUBO Naoko
• 金额: $ 1.41万
• 依托单位: Nippon Medical School
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13671412/
• 关键词: surgical stress; cytokine; heparin; m-RNA; endotoxin shock; endotherial cell; coronary artery bypass grafting; olprinone hydrochloride; 塩酸パパベリン; 人工心肺; 炎症性サイトカイン; mRNA

The aim of this study using leukocytes and endothelium was to assess the influence of surgical stress and the effect of protection with drugs. First, we confirmed that heparin have the protective role of endothelium function in rat model of endotoxin shock induced by lipopolysaccharide in vitro. Arteries of rats in heparin group were less relaxation rate by acetylcholine than in control group.Secondly, we investigated at twenty patients who had coronary artery bypass grafting m-RNA level of cytokine without cardiopulmonary bypass (off-pump CABG) which is accepted as a less invasive technique. Post operative expression of m-RNA for inter leukin-1,8,10, tumor necrosis factor-α, hemo oxygenase-1, platelet endothelial cellular adhesion molecule and Mac-1 in leukocytes of peripheral blood increased significantly in the on-pump group than in the off-pump group of which technique is associated with less invasive. In view of the m-RNA level of proinflammatory cytokines and adhesion molecules, it can be concluded that off-pump CABG is a less invasive technique than on-pump CABG. Direct contact of circulating blood with the synthetics of surfaces of the CPB system may be the main cause of the systemic inflammation.Finally, we examined the vessel relaxation rate of olprinone hydrochloride, in a piece of radial artery grafts which were harvested to use CABG. It was seen that olprinorie hydrochloride have the function of vessel relaxation the same as papaverine hydrochloride.

这项使用白细胞和内皮细胞的研究的目的是评估手术应激的影响和药物的保护效果。首先，我们在体外脂多糖诱导的内毒素休克大鼠模型中证实了肝素对内皮功能具有保护作用。乙酰胆碱组大鼠的动脉舒张率低于对照组。 其次，我们对 20 名接受冠状动脉旁路移植术的患者进行了细胞因子 mRNA 水平的调查，而没有进行体外循环 CABG（非体外循环 CABG），这种技术被认为是一种微创技术。术后外周血白细胞中白细胞介素-1、8、10、肿瘤坏死因子-α、血氧酶-1、血小板内皮细胞粘附分子和Mac-1 mRNA表达在体外循环组中较非体外循环组显着升高，且非体外循环组的技术侵入性较小。鉴于促炎细胞因子和粘附分子的 mRNA 水平，可以得出结论，非体外循环 CABG 是一种比体外循环 CABG 侵入性更小的技术。循环血液与CPB系统表面合成物的直接接触可能是全身炎症的主要原因。最后，我们检测了用于CABG的桡动脉移植物中盐酸奥普农的血管舒张率。可见盐酸奥普诺瑞具有与盐酸罂粟碱相同的血管松弛作用。

项目成果

Naoko Okubo, MD, Nobuo Hatori, MD, PhD, Masami Ochi, MD, Shigeo Tanaka, MD: "Comparison of m-RNA expression for Inflammatory Mediators in Leukocyte Between On-pump and Off-pump Coronary Artery Bypass Grafting"Annals of Thoracic and Cardiovascular Surgery.

Naoko Okubo, MD、Nobuo Hatori, MD、PhD、Masami Ochi, MD、Shigeo Tanaka, MD：“体外循环和非体外循环冠状动脉旁路移植术中白细胞炎症介质 mRNA 表达的比较”胸外科年鉴

大久保 直子: "Comparison of m-RNA Expression for Inflammatory Mediators in Leukocytes between On-pump and Off-pump CABG"Annals of Thoracic and Cardiovascular Surgery. Vol.9. 43-49 (2003)

Naoko Okubo：“体外循环 CABG 中白细胞炎症介质的 m-RNA 表达比较”《胸腔和心血管外科年鉴》第 9 卷（2003 年）。