去肾交感神经术对猪急性心肌梗死后心功能及心室重构的影响  

Effect of renal sympathetic denervation on cardiac function and ventricular remodeling after acute myocardial infarction in pigs

作　　者：谢赟[1] 郜俊清[2] 刘奇良[1] 严鹏勇[2] 张文全[2] 徐佑龙[2] 王明瑜[2] 刘宗军[2] 

机构地区：[1]上海市普陀区人民医院心内科,200060 [2]上海中医药大学附属普陀医院心内科

出　　处：《国际心血管病杂志》2016年第4期239-242,共4页International Journal of Cardiovascular Disease

基　　金：上海市普陀区科技自主创新资助项目(普KW12201)

摘　　要：目的:探讨去肾交感神经术(renal sympathetic denervation,RDN)对急性心肌梗死(AMI)后心功能及心室重构的影响。方法:微球栓塞前降支中远端构建AMI猪模型。实验分组为:对照组,建模后未接受RDN(n=10);RDN组,建模后1周接受RDN(n=10)。建模后1周(RDN前)及建模后4周对两组猪利用超声心动图检测左心功能和左心室大小,并检测相关血清学指标。结果:建模后4周,与对照组相比,RDN组的左室射血分数(EF)明显升高[(55.34±7.12)%对(50.52±2.23)%,P=0.035],左室收缩末期内径(LVESD)明显减小[(24.43±2.23)mm对(29.33±3.53)mm,P=0.020];与自身RDN治疗前比较,RDN组EF[(55.34±7.12)%对(49.23±4.58)%,P=0.034]和E/A(0.93±0.24对0.85±0.10,P=0.048)明显升高,LVESD明显减小[(24.43±2.23)mm对(26.55±2.11)mm,P=0.048];RDN组的去甲肾上腺素[(247.31±103.13)ng/L对(337.90±60.33)ng/L,P<0.05]和肾素[(414.92±202.40)ng/L对(587.54±235.62)ng/L,P<0.05)]水平显著低于对照组。结论:RDN可以提高猪AMI后的左心收缩功能,改善心室重构。Objective： To explore the effects of renal sympathetic denervation （RDN） on cardiac function and ventricular remodling after acute myocardial infarction （AMI） . Methods： AMI in pigs were induced by injecting microspheres into the left anterior descending artery. 20 AMI pigs were randomly divided into two groups： control group,pigs with AMI only （n = 10）; RDN group, pigs with RDN one week after AMI （n = 10）. One week and four weeks after modeling, left ventricular function and left ventricular size were detected by echocardiography. The related serological indexes were also detected. Results：Four weeks after modeling, LVEF of RDN group increased significantly as compared with control group [（55. 34 ± 7. 12）% vs （50. 52 ± 2. 23）%, P = 0. 035], and LVESD decreased significantly [（24. 43 ± 2. 23） rnm vs （29. 33 ± 3. 53） mm, P = 0. 320]. Compared with one week after modeling, LVEF and E/A of RDN group at four weeks after modeling increased significantly [（55.34 ± 7. 12）% vs （49. 23 ± 4. 58）%,P= 0. 034; 0. 93 ± 0. 24 vs 0. 85 ± 0. 10, P= 0. 048], and LVESD decreased significantly [（24. 43 ± 2. 23） mm vs （26. 55 ± 2. 11） mm, P = 0. 048]. Four weeks after modeling, norepinephrine and renin levels of RDN group were both significantly lower than control group [（247. 31 ± 103.13） ng/L vs （337. 90 ± 60. 33） ng/L, P〈0. 05 ; （414. 92 ± 202. 40） ng/L vs （587. 54 ± 235. 62） ng/L, P〈0. 05]. Conclusion： RDN can improve left ventricular function and attenuate ventricular remodeling after AMI in pigs.

关 键 词：去肾交感神经 急性心肌梗死 心室重构 心功能 

分 类 号：R542.22[医药卫生—心血管疾病]