去肾交感神经术治疗犬心肌梗死的效果及机制探讨

发布时间：2018-08-14 12:58

【摘要】：目的观察去肾交感神经术(RDN)治疗犬心肌梗死(简称心梗)的效果,并探讨其相关机制。方法 18只健康杂种犬随机分为对照组、模型组、治疗组,每组6只。模型组、治疗组采用明胶海绵栓塞法建立前壁心梗模型;造模后1周,治疗组行RDN手术,模型组只行肾动脉造影检查。分别于造前及造模后4周检测左心室射血分数(LVEF)、短轴缩短率(FS)、左心室舒张末期压(LVEDP)、左心室收缩末期压(LVSP)及心率(HR)。造模后4周采用苦味酸比色法测定血肌酐。建模后4周处死动物,留取梗死周边区组织(对照组取同一部位组织),HE染色观察心肌形态及结构改变;同时检测心肌组织AngⅡ、Ang1-7、ACE2 mRNA、MasR mRNA。建模后4周,留取实验犬肾动脉组织,采用免疫组化染色观察肾动脉酪氨酸羟化酶(TH)阳性神经纤维形态及分布情况并进行定量分析。结果模型组和治疗组造模后4周LVEDP高于对照组,LVEF、FS、LVSP低于对照组(P均0.05);治疗组LVEDP低于模型组,LVEF高于模型组(P均0.05)。对照组、模型组和治疗组血肌酐水平相比,P均0.05。治疗组较模型组梗死周边区病理改变明显减轻。模型组和治疗组心肌组织中AngⅡ、Ang1-7水平及ACE2 mRNA、MasR mRNA相对表达量高于对照组,治疗组AngⅡ、Ang1-7水平及ACE2 mRNA、MasR mRNA相对表达量低于模型组(P均0.05)。治疗组与模型组相比,TH阳性神经纤维形态及分布趋于正常,且治疗组TH阳性神经纤维相对表达量低于模型组(P0.05)。结论 RDN治疗犬心梗有效,可改善心功能,减轻心肌病理改变,作用可能与AngⅡ、Ang1-7、ACE2、MasR水平下调及ACE-AngⅡ-AT1R轴与ACE2-Ang1-7-MasR轴功能失衡改善有关。
[Abstract]:Objective to observe the effect of (RDN) in the treatment of canine myocardial infarction (MI) and to explore its related mechanism. Methods 18 healthy mongrel dogs were randomly divided into control group, model group and treatment group with 6 dogs in each group. Model group, the treatment group was embolized with gelatin sponge to establish the model of anterior myocardial infarction, 1 week after the model, the treatment group underwent RDN operation, and the model group only underwent renal arteriography. Left ventricular ejection fraction (LVEF),) short axis shortening rate (LEF) (FS), left ventricular end-diastolic pressure (FS),) (LVEDP), left ventricular end-systolic pressure (LVSP) and heart rate (HR). Were measured before and 4 weeks after modeling. Serum creatinine was determined by picric acid colorimetry 4 weeks after modeling. The animals were killed 4 weeks after modeling, and the myocardial morphology and structure were observed by HE staining and Ang 鈪，

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