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A Study of Influential Factors on the Endothelium Function of Great Saphenous Vein Bypass

Author: LiZhenKun
Tutor: LiShiKang
School: Guangxi Medical University
Course: Science in cardiothoracic surgery
Keywords: Coronary artery bypass grafting Saphenous vein Bypass vascular Smoke Type 2 diabetes mellitus Endothelial function
CLC: R654.2
Type: Master's thesis
Year: 2011
Downloads: 35
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Abstract

Objective: This study is divided into four parts: 1) drawn to explore the proximal and distal ends of the great saphenous vein (GSV) bypass vascular endothelial function; 2) to explore the impact of smoking on the GSV bypass vascular endothelial function; 3) GSV bypass vascular endothelial function in type 2 diabetes mellitus (T2DM); 4) to explore tetrahydrobiopterin (BH4) preservation solution GSV bypass vascular endothelial function in smoking patients. Methods: 1) randomly selected coronary artery bypass grafting (CABG) patients, 36 cases were taken to the proximal and distal ends of each patient GSV about 0.5cm. The organ bath method to detect different concentrations (10-9 ~ 10-5mol / L) and phenylephrine (PE), norepinephrine (NE), changes in vascular tone caused by acetylcholine (ACh) and nitroglycerin (NTG) ; 2) select the row CABG patients (n = 31) of the GSV about 1cm, including 12 cases of smokers, quit smoking for more than 1 year and 9 cases, non-smokers, 10 cases. Organ bath method to detect changes in vascular tone caused by the different concentrations (10-9 ~ 10-5mol / L) after 10-5mol / L PE pre-contraction ACh and NTG, and take part of the blood vessels in each group for routine pathological examination; 3) select line CABG patients (40 cases) the GSV of about 1cm, including coronary heart disease with T2DM were 20 cases, coronary heart disease unconsolidated T2DM were 20 cases detected using an organ bath method 10-5mol / L PE pre-contraction ACh and NTG concentration (10-9 ~ 10-5mol / L) caused by changes in vascular tone and take groups of blood vessels for routine pathological examination; 4) Select the line CABG in 22 patients GSV about 1cm, including smoking 12 patients with non-smokers, 10 cases of organ groove of BH4 detection, different concentrations of L-NNA preservation solution before and after immersion ,10-5mol / L PE pre-contraction (10-9 ~ 10-5mol / L) A23187 caused by changes in vascular tone, and observed BH4 preservation solution on endothelial cells. Results: 1) proximal and distal end GSV vascular, PE, NE induced contraction and ACh, NTG-induced vasodilation response difference was not statistically significant (P gt; 0.05); 2) smoking group smoking cessation group compared with the non-smoking group, the PE-induced contractile response and NTG induced endothelium dependent vasodilation reaction three groups showed no significant difference (P gt; 0.05), while the ACh-induced endothelium-dependent vasodilation reaction smoking group was significantly lower than non-smoking groups and smoking cessation group (P lt; 0.05), the difference between nonsmokers and smoking cessation group had no statistical significance (P gt; 0.05); smoking group easier endothelial cell necrosis, was not continuous endothelial pathological manifestations levy intimal hyperplasia hypertrophy, subendocardial vacuolization of endothelial injury; 3) combined T2DM group compared with the non-diabetic group, the PE-induced contractile response and NTG induced endothelium-dependent relaxation response to two groups the difference was not statistically significant (P gt; 0.05), while the ACh caused endothelium-dependent vasodilation was significantly lower (P lt; 0.05), more likely to be found pathological manifestations of endothelial damage; 4) BH4 soaked the Smoking group of vascular endothelial dependent diastolic response before immersion significantly enhanced, and the difference was not statistically significant (P gt; 0.05) with the non-smoking group, and found no evidence of damage BH4 soaked endothelial cells. Conclusions: 1) a GSV bypass vascular mesial distal end of endothelium-dependent and endothelium-dependent vasomotor response similar; 2) GSV bypass endothelium-dependent relaxation inhibit long-term smoking, quit smoking more than 1 year favorable for this function recovery 3) T2DM patients with coronary heart disease will increase GSV bypass vascular endothelial damage. 4) BH4 soak conducive to the recovery of the vascular endothelial function and soak for no obvious damage to the endothelial cells.

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