Han Wenzheng, Fang Weiyi, Gan Qian, Guan Shaofeng, Li Yanjie, Wang Ming, Gong Kaizheng, Qu Xinkai
Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
Department of Cardiology, The Second Clinical Medical College, Yangzhou University, Jiangsu, China.
J Am Soc Hypertens. 2017 May;11(5):314-320. doi: 10.1016/j.jash.2017.02.006. Epub 2017 Mar 2.
Recently, the effectiveness of renal sympathetic nerve denervation for treatment of hypertension has been doubted after SYMPLICITY HTN-3 trial. An ideal animal model is still unavailable for preclinical study about catheter-based renal sympathetic nerve denervation for treatment of hypertension. Traditional high-dose deoxycorticosterone acetate (DOCA)-induced hypertension pig model has some problems due to extensive end-organ damage. Based on the similarity in the anatomic characteristics of renal artery between pigs and humans, this study was undertaken to establish a low-dose sustained-release DOCA-induced hypertension model in pigs. A total of 14 pigs were subcutaneously implanted with low-dose DOCA in the abdomen and cannulated from the femoral artery for the measurement of blood pressure (BP). Plasma angiotensin I (Ang I), angiotensin II (Ang II), plasma renin activity (PRA), aldosterone (Ald), creatinine, epinephrine, and norepinephrine (NE) were determined before and after treatments. The kidneys were collected and processed for hematoxylin and eosin staining, Masson-Goldner trichromic, and periodic acid Schiff staining. Ten pigs survived for 1 month. Mean BP significantly increased after 2-week treatment (P < .001). The plasma Ang I, Ang II, PRA, and Ald significantly decreased (Ang I: 6.92 ± 6.06 vs. 2.22 ± 3.08, P = .002; Ang II: 768.85 ± 525.8 vs. 213.76 ± 148.63, P = .003; PRA: 1.68 ± 1.67 vs. 0.29 ± 0.39, P = .008; Ald: 0.37 ± 0.12 vs. 0.25 ± 0.09, P < .001), but norepinephrine significantly increased (7.59 ± 4.57 vs. 16.96 ± 10.38, P = .021). Plasma creatinine remained unchanged. Hisotological examination showed mild damage to the kidney. Low-dose sustained-release DOCA is able to induce hypertension in pigs. A femoral catheter is not only helpful for monitoring BP, but can be used to quickly exchange the renal sympathetic nerve denervation equipment.
最近,在SYMPLICITY HTN-3试验之后,肾交感神经去神经支配术治疗高血压的有效性受到质疑。目前仍缺乏理想的动物模型用于基于导管的肾交感神经去神经支配术治疗高血压的临床前研究。传统的高剂量醋酸脱氧皮质酮(DOCA)诱导的高血压猪模型存在一些问题,因为会造成广泛的终末器官损伤。基于猪与人肾动脉解剖特征的相似性,本研究旨在建立一种低剂量缓释DOCA诱导的猪高血压模型。总共14头猪在腹部皮下植入低剂量DOCA,并从股动脉插管以测量血压(BP)。在治疗前后测定血浆血管紧张素I(Ang I)、血管紧张素II(Ang II)、血浆肾素活性(PRA)、醛固酮(Ald)、肌酐、肾上腺素和去甲肾上腺素(NE)。收集肾脏并进行苏木精和伊红染色、马松-戈德纳三色染色以及过碘酸希夫染色。10头猪存活了1个月。治疗2周后平均血压显著升高(P <.001)。血浆Ang I、Ang II、PRA和Ald显著降低(Ang I:6.92±6.06对2.22±3.08,P =.002;Ang II:768.85±525.8对213.76±148.63,P =.003;PRA:1.68±1.67对0.29±0.39,P =.008;Ald:0.37±0.12对0.25±0.09,P <.001),但去甲肾上腺素显著升高(7.59±4.57对16.96±10.38,P =.021)。血浆肌酐保持不变。组织学检查显示肾脏有轻度损伤。低剂量缓释DOCA能够诱导猪高血压。股动脉导管不仅有助于监测血压,还可用于快速更换肾交感神经去神经支配设备。