冠状动脉旁路移植术后血管桥通畅性的研究进展
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摘要
冠状动脉旁路移植术是当代医学公认的治疗冠心病最有效的手术方法,但是移植血管桥在术后出现狭窄一直是影响手术疗效的重要因素。很多因素都会影响血管桥的术后通畅性,其中包括移植材料的组织学及生理学特性、一些生长因子的作用、手术相关因素、新技术的采用、移植血管桥的慢性感染、患者是否合并有其他基础疾病、术后用药的合理性、移植后血流环境的改变导致的血管生理生化功能的改变及患者术后的生活习惯等。其中,术后中期血管桥狭窄与内膜增厚密切相关,而如何抗平滑肌细胞增殖及内膜增厚的相关研究则有所欠缺。同时,通过前期力学实验发现:静脉血管桥在移植动脉系统后其生物力学性能较移植前发生了明显变化,因此,术后静脉血管桥的狭窄与其力学参数的变化是否存在着某种联系及其规律尚需进一步探讨。最后,随着分子生物学及基因学、新材料学科、理工科和医学交叉及融合的新探索,将会发现更多影响术后血管桥通畅性的关键因素,或许可以从更加全面的视角综合干预、改善冠脉搭桥术后血管桥的中远期通畅性。
引文
[1] KIM L K,LOOSER P,SWAMINATHAN R V,et al. Outcomesin patients undergoing coronary artery bypass graft surgery inthe United States based on hospital volume,2007 to 2011[J]. JThorac Cardiovasc Surg,2016,151(6):1686-1692.
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[3] YAMASAKI M,DEB S,TSUBOTA H,et al. Comparison of ra-dial artery and saphenous vein graft stenosis more than 5 yearsafter coronary artery bypass grafting[J]. Ann Thorac Surg,2016,102(3):712-719.
[4] CETIN E,TOLA M,OZYUKSEL A,et al. Evaluation of the re-lation between fractional flow reserve and midterm graft patencyin CABG patients[J]. J Cardiovasc Surg,2014,2(1):1.
[5]邱宗利. B型脑利钠肽联合心肌酶谱检测在冠心病危险分层和冠脉搭桥术中的预测作用[J].实用医学杂志,2015,31(8):1259-1262.
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[9]李建荣,刘永民,郑军,等.冠状动脉旁路移植术序贯和单一静脉桥通畅率荟萃分析[J].心肺血管病杂志,2015,34(4):299-304.
[10]鲁成昊.围手术期输注红细胞对不停跳冠脉旁路移植术后近期桥血管通畅率的影响[D].安徽医科大学,2017.
[11] SEKI T,YOSHIDA T. Comparison of mid-term graft patency be-tween on-pump and off-pump coronary artery bypass grafting[J]. Ann Thorac Cardiovasc Surg,2017,23(3):141-148.
[12] BEN-GAL Y,TAGGART D P,WILLIAMS M R,et al. Expand-able external support device to improve saphenous vein graft pa-tency after CABG[J]. J Cardiothorac Surg,2013,8:122.
[13] LI F D,EAGLE S,BROPHY C,et al. Pressure control duringpreparation of saphenous veins[J]. JAMA Surg,2014,149(7):655-662.
[14] ATTMANN T,GROTHUSEN C,REINSDORF A,et al. Use ofthe eSVS mesh during CABG:Computed tomographic evaluation after 6 months[J]. Thorac Cardiovasc Surg,2014,62(S01).
[15]张家庆,王武军,闫玉生.小口径人工血管材料应用进展[J].实用医学杂志,2014,30(21):3520-3521.
[16] QU Q,BING W,MENG X,et al. Upregulation of miR-126-3ppromotes human saphenous vein endothelial cell proliferation invitro and prevents vein graft neointimal formation ex vivo and invivo[J]. Oncotarget,2017,8(63):106790-106806.
[17] MIYACHI H,TAKAHASHI M,KOMORI K. A Novel approachagainst vascular intimal hyperplasia through the suppression ofgirdin[J]. Ann Vasc Dis,2015,8(2):69-73.
[18] HABIB H,MOHAMMAD A S,MEHDI F N,et al. Cytomegalo-virus infection and atherosclerosis in candidate of coronary ar-tery bypass graft[J]. Jundishapur J Microbiol,2015,8(3):e15476.
[19] KARBASIAFSHAR R,KHEDMAT H,IZADI M. Helicobacterpylori Infection and atherosclerosis:a systematic review[J]. Ac-ta Med Iran,2015,53(2):78-88.
[20] AGIRBASLI M. Influence of diabetes on CABG patency:target-ing functional status after CABG in patients with DM[J]. J AmColl Cardiol,2017,70(20):2604.
[21]黄福美,陈彩玲,赖雯苑,等.糖尿病合并复杂冠脉病变患者药物支架术与搭桥术疗效的Meta分析[J].实用医学杂志,2014(17):2818-2821.
[22] CHEN C H,LIN C L,KAO C H. Association between gastro-esophageal reflux disease and coronary heart disease:A nation-wide population-based analysis[J]. Medicine(Baltimore),2016,95(27):e4089.
[23] EBRAHIMI R,GUPTA S,CARR B M,et al. Comparison ofoutcomes and costs associated with Aspirin+/-Clopidogrel aftercoronary artery bypass grafting[J]. Am J Cardiol,2018,121(6):709-714.
[24] KULIK A,ABREU A M,BORONAT V,et al. Intensive versusmoderate atorvastatin therapy and one-year graft patency afterCABG:Rationale and design of the ACTIVE(aggressive choles-terol therapy to inhibit vein graft events)randomized controlledtrial(NCT01528709)[J]. Contemp Clin Trials,2017,59:98-104.
[25] BODEN W E,MANCINI G B. CABG for Complex CAD:Whenwill evidence-based practice align with evidence-based medicine[J]. J Am Coll Cardiol,2016,67(1):56-58.
[26]刘小丽.护心方对冠脉搭桥术后桥血管远期通畅率影响的临床研究[D].广州中医药大学,2014.
[27] INDERBITZIN D T,BREMERICH J,MATT P,et al. One-year patency control and risk analysis of eSVS?-mesh-supportedcoronary saphenous vein grafts[J]. J Cardiothorac Surg,2015,10:108.
[28]刘国鹏,尚亮,肖苍松,等.非体外循环下冠状动脉旁路移植术的远期桥血管通畅率调查[J].中华医学杂志,2017,97(22):1710-1713.
[29] HUO Y,KASSAB G S. Scaling laws of coronary circulation inhealth and disease[J]. J Biomech,2016,49(12):2531-2539.
[2] TRANBAUGH R F,SCHWANN T A,SWISTEL D G,et al.Coronary artery bypass graft surgery using the radial artery,right internal thoracic artery,or saphenous vein as the secondconduit[J]. Ann Thorac Surg,2017,104(2):553-559.
[3] YAMASAKI M,DEB S,TSUBOTA H,et al. Comparison of ra-dial artery and saphenous vein graft stenosis more than 5 yearsafter coronary artery bypass grafting[J]. Ann Thorac Surg,2016,102(3):712-719.
[4] CETIN E,TOLA M,OZYUKSEL A,et al. Evaluation of the re-lation between fractional flow reserve and midterm graft patencyin CABG patients[J]. J Cardiovasc Surg,2014,2(1):1.
[5]邱宗利. B型脑利钠肽联合心肌酶谱检测在冠心病危险分层和冠脉搭桥术中的预测作用[J].实用医学杂志,2015,31(8):1259-1262.
[6] TASOGLU I,TURAK O,NAZLI Y,et al. Preoperative neutro-phil-lymphocyte ratio and saphenous vein graft patency after cor-onary artery bypass grafting[J]. 2014,20(8):819-824.
[7] SONGUR M?,?ZYAL?IN S,?ZEN A,et al. Does really pre-vious stenting affect graft patency following CABG? A 5-yearfollow-up:The effect of PCI on graft survival[J]. Heart Ves-sels,2016,31(4):457-464.
[8] KOPJAR T,IVANKOVIC S,LIMA M L,et al. Endoscopic orno-touch vein harvesting for CABG:What is best for the patient[J]. Braz J Cardiovasc Surg,2016,31(6):461-464.
[9]李建荣,刘永民,郑军,等.冠状动脉旁路移植术序贯和单一静脉桥通畅率荟萃分析[J].心肺血管病杂志,2015,34(4):299-304.
[10]鲁成昊.围手术期输注红细胞对不停跳冠脉旁路移植术后近期桥血管通畅率的影响[D].安徽医科大学,2017.
[11] SEKI T,YOSHIDA T. Comparison of mid-term graft patency be-tween on-pump and off-pump coronary artery bypass grafting[J]. Ann Thorac Cardiovasc Surg,2017,23(3):141-148.
[12] BEN-GAL Y,TAGGART D P,WILLIAMS M R,et al. Expand-able external support device to improve saphenous vein graft pa-tency after CABG[J]. J Cardiothorac Surg,2013,8:122.
[13] LI F D,EAGLE S,BROPHY C,et al. Pressure control duringpreparation of saphenous veins[J]. JAMA Surg,2014,149(7):655-662.
[14] ATTMANN T,GROTHUSEN C,REINSDORF A,et al. Use ofthe eSVS mesh during CABG:Computed tomographic evaluation after 6 months[J]. Thorac Cardiovasc Surg,2014,62(S01).
[15]张家庆,王武军,闫玉生.小口径人工血管材料应用进展[J].实用医学杂志,2014,30(21):3520-3521.
[16] QU Q,BING W,MENG X,et al. Upregulation of miR-126-3ppromotes human saphenous vein endothelial cell proliferation invitro and prevents vein graft neointimal formation ex vivo and invivo[J]. Oncotarget,2017,8(63):106790-106806.
[17] MIYACHI H,TAKAHASHI M,KOMORI K. A Novel approachagainst vascular intimal hyperplasia through the suppression ofgirdin[J]. Ann Vasc Dis,2015,8(2):69-73.
[18] HABIB H,MOHAMMAD A S,MEHDI F N,et al. Cytomegalo-virus infection and atherosclerosis in candidate of coronary ar-tery bypass graft[J]. Jundishapur J Microbiol,2015,8(3):e15476.
[19] KARBASIAFSHAR R,KHEDMAT H,IZADI M. Helicobacterpylori Infection and atherosclerosis:a systematic review[J]. Ac-ta Med Iran,2015,53(2):78-88.
[20] AGIRBASLI M. Influence of diabetes on CABG patency:target-ing functional status after CABG in patients with DM[J]. J AmColl Cardiol,2017,70(20):2604.
[21]黄福美,陈彩玲,赖雯苑,等.糖尿病合并复杂冠脉病变患者药物支架术与搭桥术疗效的Meta分析[J].实用医学杂志,2014(17):2818-2821.
[22] CHEN C H,LIN C L,KAO C H. Association between gastro-esophageal reflux disease and coronary heart disease:A nation-wide population-based analysis[J]. Medicine(Baltimore),2016,95(27):e4089.
[23] EBRAHIMI R,GUPTA S,CARR B M,et al. Comparison ofoutcomes and costs associated with Aspirin+/-Clopidogrel aftercoronary artery bypass grafting[J]. Am J Cardiol,2018,121(6):709-714.
[24] KULIK A,ABREU A M,BORONAT V,et al. Intensive versusmoderate atorvastatin therapy and one-year graft patency afterCABG:Rationale and design of the ACTIVE(aggressive choles-terol therapy to inhibit vein graft events)randomized controlledtrial(NCT01528709)[J]. Contemp Clin Trials,2017,59:98-104.
[25] BODEN W E,MANCINI G B. CABG for Complex CAD:Whenwill evidence-based practice align with evidence-based medicine[J]. J Am Coll Cardiol,2016,67(1):56-58.
[26]刘小丽.护心方对冠脉搭桥术后桥血管远期通畅率影响的临床研究[D].广州中医药大学,2014.
[27] INDERBITZIN D T,BREMERICH J,MATT P,et al. One-year patency control and risk analysis of eSVS?-mesh-supportedcoronary saphenous vein grafts[J]. J Cardiothorac Surg,2015,10:108.
[28]刘国鹏,尚亮,肖苍松,等.非体外循环下冠状动脉旁路移植术的远期桥血管通畅率调查[J].中华医学杂志,2017,97(22):1710-1713.
[29] HUO Y,KASSAB G S. Scaling laws of coronary circulation inhealth and disease[J]. J Biomech,2016,49(12):2531-2539.