南方医科大学学报

南方医科大学学报 ›› 2021, Vol. 41 ›› Issue (11): 1609-1615.doi: 10.12122/j.issn.1673-4254.2021.11.03

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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

叶 飞，史桂霞，王晓艳，涂 珊，张志辉，曾丽雄   

  1. 中南大学湘雅三医院心内科，湖南 长沙 410013；长沙卫生职业学院，湖南 长沙 410013
  • 出版日期:2021-11-20 发布日期:2021-12-10

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

YE Fei, SHI Guixia, WANG Xiaoyan, TU Shan, ZHANG Zhihui, ZENG Lixiong   

  1. Department of Cardiology,Third Xiangya Hospital of Central South University, Changsha 410013, China; Internal Medicine, Changsha Health Vocational College, Changsha 410013, China
  • Online:2021-11-20 Published:2021-12-10

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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Ang Ⅱ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。

关键词: 高血压；肾交感神经射频消融术；动脉硬度；交感活性

Abstract: 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 significantly reduce blood pressure and improve arterial stiffness in hypertensive beagles possibly by reducing sympathetic activity and blood pressure and promoting NO synthesis.

Key words: hypertension; renal sympathetic denervation; arterial stiffness; sympathetic activity