基于超声对比成像的自发性高血压大鼠肾去神经降压作用。

Hypotensive effects of renal denervation in spontaneously hypertensive rat based on ultrasonic contrast imaging.

机构信息

Department of Cardiology, Hainan Branch of Chinese PLA General Hospital, Sanya 572013, China.

Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.

出版信息

Comput Med Imaging Graph. 2017 Jun;58:56-61. doi: 10.1016/j.compmedimag.2017.01.006. Epub 2017 Feb 9.

DOI:10.1016/j.compmedimag.2017.01.006

PMID:28314642

Abstract

BACKGROUND

Sympathetic nerves-fire rate is generally enhanced in some types of hypertension models. Renal sympathetic denervation(RSD) by the radiofrequency ablation was used to treat the hypertension has achieved curative effect.HTN-1 and HTN-2 trial reported catheter-based renal denervation may cause substantial and sustained blood-pressure reduction in patients with resistant hypertension. However, recent controlled HTN-3 trial questioned the BP lowering effect of Renal denervation treatment. The controversial results maybe arised from the incompleted RSD which implemented inside the renal artery. Now renal denervation therapy for resistant hypertension is in attractive and controversial status. Our aim is to define the hyotensive value of complete renal denervation in adult spontaneous hypertensive rats.

METHODS

Male spontaneous hypertensive rats(SHR) aged 12 weeks were randomly selected for either unilateral renal artery sympathetic nerves ablation (URSNA), or conventional technique of renal denervation (CRD), or bilateral renal artery sympathetic nerves ablation (BRSNA) and sham operation. Blood pressure, sodium and water balance,serum reninangiotensin II and Norepinephrine concentration were measured during 20 weeks after renal denervation operation. Internal diameters of renal arteries and renal blood flow rate was tested by ultrasonic contrast imaging.

RESULTS

The continued increased blood pressure in SHR was delayed and significantly reduced by conventional renal denervation over a period of 8 weeks. Both the bilateral and unilateral renal sympathetic nerve ablation procedure did not prevent the development of hypertension in SHR. The attenuation of hypertension was accompanied with the increase of urinary sodium excretion and depression of rennin angiotensin system (RAS).

CONCLUSIONS

We concluded that renal denervation may not be an effective therapeutic method in the long-term control of hypertension in adult SHR.

摘要

背景

在某些类型的高血压模型中，交感神经的冲动频率通常会增强。通过射频消融术进行的肾交感神经去神经支配（RSD）已被用于治疗高血压，并已取得疗效。HTN-1 和 HTN-2 试验报告称，基于导管的肾去神经支配可能会导致耐药性高血压患者的血压显著且持续降低。然而，最近的对照 HTN-3 试验对肾去神经支配治疗的降压效果提出了质疑。有争议的结果可能源于肾动脉内不完全的 RSD。目前，用于耐药性高血压的肾去神经治疗仍处于有吸引力和有争议的地位。我们的目的是确定完全肾去神经支配在成年自发性高血压大鼠中的降压价值。

方法

随机选择 12 周龄雄性自发性高血压大鼠（SHR）进行单侧肾动脉交感神经消融术（URSNA）、常规肾去神经术（CRD）、双侧肾动脉交感神经消融术（BRSNA）或假手术。在肾去神经术后 20 周内测量血压、钠水平衡、血清肾素血管紧张素 II 和去甲肾上腺素浓度。通过超声对比成像测试肾动脉内径和肾血流量。