肾脏去交感神经对肾性高血压的影响及预测指标的筛选  

Effects of renal sympathetic denervation on renal hypertension and selection of predictor

作　　者：尚福军[1] 王捷频[2] 于亮[1] 刘雄涛[1] 李雪[1] 

机构地区：[1]第四军医大学唐都医院心内科,西安710038 [2]第四军医大学唐都医院药剂科,西安710038

出　　处：《岭南心血管病杂志》2015年第6期858-861,共4页South China Journal of Cardiovascular Diseases

基　　金：西安市医学攻关计划项目资助(项目编号:SF1201)

摘　　要：目的观察肾脏去交感神经治疗(renal sympathetic denervation,RSD)对肾性高血压的影响,并初步筛选预测降压治疗效果的生化指标。方法采用单侧肾动脉缩窄及同侧肾脏包扎方法建立肾性高血压兔模型,建模2个月后通过经腹肾动脉外膜消融法达到RSD效果,RSD后2个月测定血压,并采用酶联免疫吸附试验(ELISA)检测消融前和消融后2个月血浆中去甲肾上腺素(norepinephrine,NE)、精氨酸血管加压素(arginine vasopressin,AVP)、血管紧张素II(angiotensin II,Ang II)、醛固酮(aldosterone,ALD)等血管活性物质的浓度。结果与对照组比较,肾性高血压动物收缩压显著升高,差异有统计学意义(P<0.05)。RSD可显著降低高血压动物的收缩压(P<0.05),但RSD对正常血压组动物血压无显著影响(P>0.05)。肾性高血压动物血浆NE、Ang II及ALD浓度均较对照组明显升高,差异有统计学意义(P<0.05);AVP浓度变化不明显(P>0.05)。RSD后高血压动物血浆NE、Ang II及ALD浓度显著下降,差异有统计学意义(均P<0.05)。相关分析显示高血压动物RSD前血浆NE、Ang II及ALD浓度与血压下降幅度呈正相关(均P<0.05)。结论 RSD可以降低肾源性高血压,NE、Ang II和ALD可作为RSD治疗肾性高血压的初筛指标。Objectives To investigate the effects of renal sympathetic denervation （RSD） on renal hypertension and to screen effective predictors of neurohormonal factors. Methods We established rabbit models of renal hypertension by unilateral renal artery constriction and renal-wrap procedure. Two months later, RSD was carried out by transabdominal radiofrequency ablation of renal arterial adventitia. Two months after RSD, blood pressure was measured. Plasma concentrations of norepinephrine （ NE ）, arginine vasopressin （AVP）, angiotensin II （Ang II） and aldosterone （ALD） prior to and 2 months post-RSD were determined by enzyme-linked immunosorbent assay （ELISA）. Results Systolic blood pressure （SBP） in rabbits with renal hypertension increased significantly compared with that in control rabbits （P〈0.05）. Two months after RSD, SBP in ablation group was lower than that in hypertension group （P〈0.05）. There is no significant difference between ablation group and control group （P〉0.05）. Cmnpared with control group, plasma concentrations of NE, Ang II and ALD were significantly higher in hypertension group （P〈0.05）, but AVP was similar （P〉0.05）. Plasma concentrations of NE, Ang II and ALD in ablation group declined after RSD （P〈0.05）. Correlation analysis demonstrated that reduction in blood pressure by RSD was positively correlated to the plasma concentrations of NE, Ang I] and ALD prior to RSD. Conclusions RSD can reduce blood pressure in renal hypertensive rabbit model. The nenrohormonal factors of NE, Ang II and ALD can be the effective predictors for the effect of RSD.

关 键 词：肾性高血压 肾脏去交感神经 神经体液因子 

分 类 号：R544.14[医药卫生—心血管疾病]