天津医药

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去肾脏交感神经术对犬高血压及内皮功能关系的研究

赵斌1,卢成志2,于翔2,王彦欧1,张欣3   

  1. 1. 天津医科大学一中心临床学院
    2. 天津市第一中心医院
    3. 天津市第一中心医院检验科
  • 收稿日期:2011-11-04 修回日期:2012-03-21 出版日期:2012-10-15 发布日期:2012-10-15
  • 通讯作者: 赵斌

The Explore Of Relation Between Renal Sympathetic Denervation for Hypertensive Dogs and The Endothelial function.

  • Received:2011-11-04 Revised:2012-03-21 Published:2012-10-15 Online:2012-10-15
  • Contact: Bin ZHAO

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摘要： 【摘要】目的 通过去肾脏交感神经术对犬高血压的治疗，探讨高血压病与交感神经兴奋及内皮功能的关系。方法 18只杂种狗随机分为干预组（n=10）和对照组（n=8）两组，干预组为高血压造模组，两组实验动物都接受去肾脏交感神经术。观察的主要指标是平均动脉血压（MAP）的变化，分别在术前和术后2,4, 10周监测MAP，在造模前、造模后和术后检测内皮素-1（ET-1）及降钙素基因相关肽 （CGRP）等指标，同时在术后2、4、10周检测干预组血管紧张素II（AngII）指标的变化，通过对这些数据进行方差分析，来探讨高血压病与交感神经兴奋及内皮功能的关系。结果 在干预组，造模后MAP、ET-1、CGRP都较造模前显著改变（P＜0.001）；在去神经术后，MAP、 ET-1、CGRP、AngII等指标都较术前有显著改变（P<0.05）结论 高血压病的发生、维持在很大程度上来源于交感神经兴奋，同时在其进程中造成了一定程度的内皮功能受损，去肾脏交感神经术通过降低交感神经活性导致显著和持久的血压下降,同时在一定程度上改善内皮功能。

关键词: 肾交感神经去除术, 交感神经过度激活, 高血压, 内皮功能

Abstract: 【ABSTRACT】Objective The aim of this study was to explore the treatment of renal sympathetic denervation for hypertension and discuss the relation between hypertension and sympathetic hyperactivity and endothelial function at the same time. Methods Eightheen mongrel dogs were studied as intervention (n=10) and control (n=8) groups. The intervention group was made the neurogenic hypertension model. Two groups received percutaneous catheter-based radiofrequency. Primary endpoints were changes of mean blood pressure (MAP) before and at 2, 4 and 10 weeks after procedure. The changes of endothelin-1 （ET-1）and calcitonin gene related peptide（CGRP）were detected at preoperation、after remolding and after procedure, and at the same time Ang II of intervention groups were also detected at 2, 6 and 10 weeks after procedure. We assessed the data changes effectiveness by repeated measures ANOVA. Results In intervention group, MAP、ET-1、CGR had changed significantly(P<0.01) after remolding, compared with baseline level, and MAP、 the level of ET-1、CGRP and AngII all changed significantly after catheter-based renal denervation (P<0.05) . Conclusion Sympathetic hyperactivity plays an important role in the progression of hypertension, and endothelial dysfunction happened in the development of hypertension. Renal sympathetic denervation causes substantial and sustained blood-pressure reduction, with Sympathetic hyperactivity reduced and the improvement of endothelial dysfunction at some degree.

Key words: Renal Sympathetic denervation, sympathetic hyperactivity, Hypertension, endothelial function