肾交感神经射频消融术可降低高血压犬血压并改善动脉硬度  

Renal sympathetic denervation can significantly reduce blood pressure and improve arterial stiffness in hypertensive beagles

作　　者：叶飞[1] 史桂霞 王晓艳[1] 涂珊[1] 张志辉[1] 曾丽雄[1] YE Fei;SHI Guixia;WANG Xiaoyan;TU Shan;ZHANG Zhihui;ZENG Lixiong(Department of Cardiology,Third Xiangya Hospital of Central South University,Changsha 410013,China;Internal Medicine,Changsha Health Vocational College,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院心内科,湖南长沙410013 [2]长沙卫生职业学院,湖南长沙410013

出　　处：《南方医科大学学报》2021年第11期1609-1615,共7页Journal of Southern Medical University

基　　金：国家自然科学基金(81870303);湖南省自然科学基金(2018JJ3800)。

摘　　要：目的了解肾交感神经射频消融术(RDN)对高血压犬血压和动脉硬度的影响并探讨RDN对动脉硬度影响的相关机制。方法将16条比格犬按2∶1∶1的比例随机分为RDN组(n=8,高盐高脂饲养构建高血压大动物模型+RDN治疗)、假手术组(n=4,高盐高脂饲养构建高血压大动物模型+肾动脉造影)和对照组(n=4,普通配方犬粮饲养)。比较3组血压、动脉硬度、内皮功能及交感活性相关指标的变化,并进行相关性分析。结果高血压犬模型全部构建成功,术后3月,3组收缩压(SBP)变化差异显著(P=0.006),RDN组SBP降幅显著大于假手术组与对照组(P<0.05),舒张压(DBP)变化亦存在显著差异(P=0.016),RDN组DBP降幅大于对照组(P=0.007),但与假手术组差异不明显(P=0.052);术后3组血管阻力指数(RI)变化幅度有显著差异(P=0.043),其中RDN组术后RI降幅显著大于对照组(P=0.032)及假手术组(P=0.043);RDN术前后的eNOS、NO及AngⅡ浓度在3组间均无显著差异(P>0.05),建模成功后RDN组血清NE浓度显著高于对照组(P=0.014)而与假手术组无统计学差异(P=0.560),术后RDN组血清NE浓度降幅大于假手术组(P=0.032)而与对照组差异不明显(P=0.080);RDN组比格犬RI的变化与SBP、DBP、NO浓度、NE浓度的变化存在显著相关性(P<0.05)。结论RDN可显著降低高血压犬的血压及改善动脉硬度,对动脉硬度的改善可能与交感活性和血压降低及促进NO合成有关。Objective To investigate the effect of renal sympathetic denervation(RDN)on blood pressure and arterial stiffness in hypertensive beagles and explore the underlying mechanism.Methods Sixteen beagles were randomly divided into RDN group(n=8,fed with a high-salt high-fat diet to establish models of hypertension and treated with RDN),sham-operated group(n=4,fed with a high-salt high-fat diet to induce hypertension but only examined with renal arteriography)and control group(n=4,fed with formula dog food).The changes in blood pressure,arterial stiffness,endothelial function,and sympathetic activity were compared among the 3 groups and correlation analysis was performed.Results All the animal models of hypertension were established successfully in the beagles.At 3 months after the RDN,the changes in systolic blood pressure(SBP)differed significantly among the 3 groups(P=0.006),and the reduction in SBP was significantly greater in RDN group than in the other two groups(P<0.05).The variations of diastolic blood pressure(DBP)also differed significantly among the 3 groups(P=0.016),and DBP reduction was more obvious in RDN group than in the control group(P=0.007),but similar to that in the sham-operated group(P=0.052).The changes of resistance index(RI)after the procedure were significantly different among the 3 groups(P=0.043),and the RDN group showed a greater reduction of RI than the control group(P=0.032)and sham group(P=0.043).Serum levels of eNOS,NO and Ang II did not differ significantly among the groups either before or after RDN(P>0.05),but serum NE level was significantly higher in RDN group than in the control groupafter successful modeling(P=0.014),but similar to that in the sham group(P=0.560).Compared with the sham operation,RDN in the hypertensive beagles resulted in a significantly greater decrease of serum NE level(P=0.032)to almost the control level(P=0.080).The changes of RI following RDN were significantly correlated with the changes of SBP,DBP and serum levels of NO and NE(P<0.05).Conclusion RDN can si

关 键 词：高血压 肾交感神经射频消融术 动脉硬度 交感活性 

分 类 号：R544.1[医药卫生—心血管疾病]