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低强度脉冲超声可提升休克时的血压。

Low-intensity pulsed ultrasound elevates blood pressure for shock.

作者信息

Wu Chenrui, Tian Yu, Liu Tao, An Shuo, Qian Yu, Gao Chuang, Yuan Jiangyuan, Liu Mingqi, Nie Meng, Jiang Weiwei, Sha Zhuang, Lv Chuanxiang, Liu Qiang, Wang Xiaochun, Zhou Sheng, Jiang Rongcai

机构信息

Department of Neurosurgery, Tianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post-Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General Hospital, Tianjin 300052, China.

Department of Neurology, Institute of Neuroimmunology, Tianjin Medical University General Hospital, Tianjin 300052, China.

出版信息

Sci Adv. 2025 Mar 21;11(12):eads6947. doi: 10.1126/sciadv.ads6947. Epub 2025 Mar 19.


DOI:10.1126/sciadv.ads6947
PMID:40106546
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11922025/
Abstract

Fluid replacement is the primary treatment for life-threatening shock but is challenging in harsh environments. This study explores low-intensity pulsed ultrasound (LIPUS) as a resuscitation strategy. Cervical LIPUS stimulation effectively elevated blood pressure in shocked rats. It also improved cerebral and multiorgan perfusion. Mechanistically, LIPUS activated pathways related to sympathetic nerve excitation and vascular smooth muscle contraction, increasing plasma catecholamines and stimulating blood pressure-regulating neural nuclei. Partial sympathetic nerve transection reduced LIPUS efficacy, while complete inhibition of these nuclei abolished the response. Preliminary clinical trials demonstrated LIPUS's ability to raise blood pressure in shock patients. The findings suggest that LIPUS enhances sympathetic nerve activity and activates blood pressure-regulating nuclei, offering a noninvasive, neuromodulation-based approach to shock treatment. This method holds potential for improving blood pressure and organ perfusion in shock patients, especially in resource-limited environments.

摘要

液体复苏是治疗危及生命的休克的主要方法,但在恶劣环境中具有挑战性。本研究探索了低强度脉冲超声(LIPUS)作为一种复苏策略。颈部LIPUS刺激可有效提高休克大鼠的血压。它还改善了脑和多器官灌注。从机制上讲,LIPUS激活了与交感神经兴奋和血管平滑肌收缩相关的通路,增加了血浆儿茶酚胺并刺激了血压调节神经核。部分交感神经横断降低了LIPUS的疗效,而完全抑制这些神经核则消除了反应。初步临床试验证明了LIPUS在休克患者中升高血压的能力。研究结果表明,LIPUS增强了交感神经活动并激活了血压调节神经核,为休克治疗提供了一种基于神经调节的非侵入性方法。这种方法在改善休克患者的血压和器官灌注方面具有潜力,尤其是在资源有限的环境中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/efbff6e3dcf2/sciadv.ads6947-f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/799300ffadfe/sciadv.ads6947-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/65b1f78c54da/sciadv.ads6947-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/12ad3548e86b/sciadv.ads6947-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/ee2fb96b259b/sciadv.ads6947-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/2ba9948b08af/sciadv.ads6947-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/ab58dcad9b6b/sciadv.ads6947-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/efbff6e3dcf2/sciadv.ads6947-f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/799300ffadfe/sciadv.ads6947-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/65b1f78c54da/sciadv.ads6947-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/12ad3548e86b/sciadv.ads6947-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/ee2fb96b259b/sciadv.ads6947-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/2ba9948b08af/sciadv.ads6947-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/ab58dcad9b6b/sciadv.ads6947-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/11922025/efbff6e3dcf2/sciadv.ads6947-f7.jpg

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引用本文的文献

[1]
Innovations in Stress Urinary Incontinence: A Narrative Review.

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本文引用的文献

[1]
Non-Invasive Ultrasound Modulation of Solitary Tract Nucleus Exerts a Sustainable Antihypertensive Effect in Spontaneously Hypertensive Rats.

IEEE Trans Biomed Eng. 2023-6

[2]
Autonomic modulation by low-intensity focused ultrasound stimulation of the vagus nerve.

J Neural Eng. 2022-12-16

[3]
The Intensivist's Perspective of Shock, Volume Management, and Hemodynamic Monitoring.

Clin J Am Soc Nephrol. 2022-5

[4]
SCAI SHOCK Stage Classification Expert Consensus Update: A Review and Incorporation of Validation Studies: This statement was endorsed by the American College of Cardiology (ACC), American College of Emergency Physicians (ACEP), American Heart Association (AHA), European Society of Cardiology (ESC) Association for Acute Cardiovascular Care (ACVC), International Society for Heart and Lung Transplantation (ISHLT), Society of Critical Care Medicine (SCCM), and Society of Thoracic Surgeons (STS) in December 2021.

J Am Coll Cardiol. 2022-3-8

[5]
A novel mechanism linking ferroptosis and endoplasmic reticulum stress via the circPtpn14/miR-351-5p/5-LOX signaling in melatonin-mediated treatment of traumatic brain injury.

Free Radic Biol Med. 2022-1

[6]
Cardiogenic Shock After Acute Myocardial Infarction: A Review.

JAMA. 2021-11-9

[7]
The Pathophysiology and Management of Hemorrhagic Shock in the Polytrauma Patient.

J Clin Med. 2021-10-19

[8]
ADGRA1 negatively regulates energy expenditure and thermogenesis through both sympathetic nervous system and hypothalamus-pituitary-thyroid axis in male mice.

Cell Death Dis. 2021-4-6

[9]
Randomized Trial of Focused Ultrasound Subthalamotomy for Parkinson's Disease.

N Engl J Med. 2020-12-24

[10]
TNF-α-induced sympathetic excitation requires EGFR and ERK1/2 signaling in cardiovascular regulatory regions of the forebrain.

Am J Physiol Heart Circ Physiol. 2021-2-1

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