Uticaj različitih tipova prezervacionih rastvora na integritet endotela safenske vene u koronarnoj hirurgiji kod bolesnika sa dijabetesom melitusom podvrgnutih hirurškoj revaskularizaciji miokarda

  • Aleksandar Kamenov University Clinical Center Niš, Cardiac Surgery Clinic, Niš, Serbia
  • Vladimir Stojiljković University Clinical Center Niš, Cardiac Surgery Clinic, Niš, Serbia
  • Aleksandar Petrović University of Niš, Faculty of Medicine, Department of Histology and Embryology, Niš, Serbia
  • Milan Lazarević University Clinical Center Niš, Cardiac Surgery Clinic, Niš, Serbia
  • Mladjan Golubović University Clinical Center Niš, Cardiac Surgery Clinic, Niš, Serbia
  • Velimir Perić University Clinical Center Niš, Cardiac Surgery Clinic, Niš, Serbia
  • Marija Stošić University Clinical Center Niš, Cardiac Surgery Clinic, Niš, Serbia
  • Goran Radenković University of Niš, Faculty of Medicine, Department of Histology and Embryology, Niš, Serbia
  • Ivan Nikolić University of Niš, Faculty of Medicine, Department of Histology and Embryology, Niš, Serbia
  • Vladimir Petrović University of Niš, Faculty of Medicine, Department of Histology and Embryology, Niš, Serbia
  • Saša Živić University Clinical Center Niš, Cardiac Surgery Clinic, Niš, Serbia
  • Dragan Milić University Clinical Center Niš, Cardiac Surgery Clinic, Niš, Serbia
DOI: https://doi.org/10.2298/VSP230312051K
Ključne reči: aortokoronarno premošćavanje, dijabetes melitus, insulin-nezavisni, histološke tehnike, rastvori za čuvanje organa, v. saphena, graftovi

Sažetak


Uvod/Cilj. Uprkos opravdanom porastu popularnosti totalne arterijske revaskularizacije, graft safenske vene (GSV) ostaje jedan od najkorišćenijih provodnika u hirurškoj revaskularizaciji miokarda (coronary artery bypass grafting – CABG). Jedan od odlučujućih faktora trajnosti tog provodnika je integritet njegovog endotela u vreme operacije. Cilj rada bio je da se kod bolesnika podvrgnutih CABG sa tip 2 dijabetesom melitusom (T2DM) i kod bolesnika bez T2DM ispita uticaj prezervacionih rastvora na integritet endotelnih ćelija GSV. Rastvori koji su procenjivani bili su: heparinizirani fiziološki rastvor (sol. 0,9% NaCl), heparinizirana puna autologna krv, Bretschneider-ov histidin-triptofan-ketoglutarat (HTK) rastvor i rastvor sveže zamrznute plazme (SZP). Metode. U studiju je bilo uključeno 40 bolesnika podeljenih u dve grupe: grupu A, u kojoj su bila 23 bolesnika sa T2DM i grupu B, sa 17 bolesnika bez T2DM. Efekti prezervacionih rastvora ispitivani su imunohistohemijskim bojenjem anti-CD34 antitelom i morfometrijskim poređenjem histoloških uzoraka bolesnika sa T2DM, podvrgnutih CABG između jula 2021. i septembra 2022. godine, sa uzorcima koji su dali bolesnici koji nisu imali T2DM. Rezultati. Najbolji efekat na očuvanje integriteta endotela GSV imao je rastvor SZP, sa prosečnim očuvanjem integriteta endotela od 92,2%. Najnepovoljniji efekat imao je rastvor HTK, sa prosečnim očuvanjem integriteta endotela od 26,77%. Nije bilo statistički značajne razlike rezultata između grupa A i B. Postojao je primetan, mada ne statistički značajan, kontrast u očuvanju integriteta endotela GSV između bolesnika sa T2DM i bolesnika bez T2DM. Zaključak. U konvencionalnom metodu CABG, prezervacioni rastvor sa najboljim efektom na očuvanje integriteta endotela GSV bio je rastvor SZP.

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Objavljeno
2023/12/29
Broj časopisa
Vol. 80 Br. 12 (2023): Vojnosanitetski pregled
Rubrika
Originalni članak