肾动脉外膜射频消融术对比格犬血压影响的初步研究

发布时间：2018-05-05 06:48

  本文选题：高血压 + 肾动脉射频消融　； 参考：《苏州大学》2016年硕士论文

【摘要】：目的:通过手术方法建立神经源性高血压比格犬模型;观察经腹肾动脉外膜射频消融去神经术对比格犬血压的影响,并初步评估其有效性与安全性。方法:10只比格犬随机分为两组(干预组6只、对照组4只),均通过经颈动脉方式制作成神经源性高血压模型,监测建模术后血压及肾交感活性物质变化。建模成功后,干预组犬在经腹手术下行肾动脉外膜射频消融去神经化治疗,对照组仅进行假手术操作。于术后2、4、6、8周监测血压变化情况,同时检测术前及术后肾功能、肾交感活性物质变化。术后8周时,各实验犬行双侧肾动脉造影观察有无异常,处死实验犬,行肾及肾动脉病理检查。结果:建模后两组犬血压均升高明显,干预组平均动脉压从术前(108.64±5.52)mm Hg升至术后(126.09±8.84)mm Hg(P0.001),肾素活性、血管紧张素Ⅱ水平同时升高(P0.001);经腹肾动脉射频消融去神经术后,平均动脉压2、4、6、8周分别降至(115.82±9.93)mm Hg(P=0.008)、(118.55±6.25)mm Hg(P=0.07)、(113.91±6.76)mm Hg(P=0.002)、(107.45±6.07)mm Hg(P0.001),同时肾素活性、血管紧张素Ⅱ水平亦表现出相同下降趋势(P0.001),肌酐等肾功能指标无明显变化(P0.05)。假手术后对照组比格犬血压无明显下降,肾素活性、血管紧张素Ⅱ仍维持在较高水平,其他各项指标均无明显变化。术后8周肾动脉造影未见肾动脉狭窄、夹层等并发症。病理检查示干预组犬肾动脉交感神经束周围的纤维结缔组织增厚,外形完整,无损伤、撕裂和夹层等,未见肾脏萎缩、坏死等病变。结论:经腹肾动脉外膜射频消融去神经术能够对比格犬产生显著且持久的血压下降作用,并降低血液中肾交感活性物质,对肾脏的形态与功能均无明显影响。
[Abstract]:Objective: to establish a neurogenic hypertensive Beagle model by surgical method, to observe the effect of radiofrequency ablation of epineurial nerve via abdominal renal artery on blood pressure, and to evaluate its efficacy and safety. Methods 10 Beagle dogs were randomly divided into two groups: intervention group (n = 6) and control group (n = 4). Neurogenic hypertension models were established by carotid artery approach. The changes of blood pressure and renal sympathetic substances after modeling were monitored. After modeling successfully, the intervention group underwent radiofrequency ablation of the renal artery epineurium and the control group only underwent sham-operation. The changes of blood pressure, renal function and renal sympathetic active substances were detected before and after operation. At 8 weeks after operation, bilateral renal arteriography was performed in each experimental dog, and the dogs were killed and the renal and renal arteries were examined. Results: after modeling, the blood pressure of the two groups increased significantly, the mean arterial pressure in the intervention group increased from 108.64 卤5.52)mm Hg to 126.09 卤8.84)mm Hg P 0.001a, the level of renin activity and angiotensin 鈪，

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