Bai Minfu, Yang Chaokuan, Gao Chuanyu, Wang Xianpei, Liu Hongzhi, Zhang You, Liu Jun, Wu Jintao, Jian Dongdong, Zhu Lijie, Zhao Wenli, Ma Peiyao, Han Yaqi
Department of Cardiology, Zhengzhou University People's Hospital, Zhengzhou, PR China.
Cardiology. 2015;131(3):189-96. doi: 10.1159/000381799. Epub 2015 May 8.
This study was designed to observe the efficacy and safety of renal denervation from the inside and outside of renal arteries.
Fourteen beagles were randomly divided into a control group (n = 4) and treatment group (n = 10). One renal artery in every beagle of the treatment group was randomly assigned to an intimal group (10 renal arteries) which underwent percutaneous renal denervation from the inside, and another renal artery was assigned to an adventitial group (10 renal arteries) which underwent renal denervation from the outside by laparotomy.
Compared with the intimal group, the renal norepinephrine (NE) concentration in the adventitial group had significantly decreased (p = 0.003) at 3 months postsurgery. Renal artery HE staining showed that the perineurium from the adventitial group appeared thickened. Western blotting showed that renal tissue tyrosine hydroxylase (TH) protein expression in the adventitial group was significantly lower than that in the intimal group (p < 0.01) at 3 months postsurgery. There was a renal artery stenosis and a renal atrophy in the intimal group after 1 month of follow-up.
The inhibitory effect on renal sympathetic nerve activity was more effective in the adventitial group than the intimal group, and renal denervation in the former group was safe.
本研究旨在观察经肾动脉内外膜进行肾去神经支配的疗效和安全性。
将14只比格犬随机分为对照组(n = 4)和治疗组(n = 10)。治疗组的每只比格犬的一条肾动脉随机分配至内膜组(10条肾动脉),该组通过经皮从肾动脉内部进行肾去神经支配;另一条肾动脉分配至外膜组(10条肾动脉),该组通过开腹手术从肾动脉外部进行肾去神经支配。
与内膜组相比,外膜组术后3个月时肾去甲肾上腺素(NE)浓度显著降低(p = 0.003)。肾动脉HE染色显示,外膜组的神经束膜增厚。蛋白质免疫印迹法显示,外膜组术后3个月时肾组织酪氨酸羟化酶(TH)蛋白表达显著低于内膜组(p < 0.01)。随访1个月后,内膜组出现1例肾动脉狭窄和1例肾萎缩。
外膜组对肾交感神经活动的抑制作用比内膜组更有效,且外膜组的肾去神经支配是安全的。