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Hypertension:靶向交感神经消融可降低遗传盐敏感性高血压

2013-03-25 xzdjh 丁香园

交感神经系统在高血压人群和Dahl盐敏感高血压大鼠模型起着一定作用,但其中涉及哪些交感神经并不清楚。为阐述这一问题,美国明尼苏达大学的研究人员对肾脏和内脏交感神经在Dahl高血压小鼠模型中的作用进行验证,他们将实验模型分为假手术组(n=10),靶向肾交感神经消融组(肾脏去神经支配组, n=11),内脏神经消融组(腹腔神经节去除组,n=11),肾脏神经和腹腔神经联合消融组(n=11)。给予0.4%氯

交感神经系统在高血压人群和Dahl盐敏感高血压大鼠模型起着一定作用,但其中涉及哪些交感神经并不清楚。为阐述这一问题,美国明尼苏达大学的研究人员对肾脏和内脏交感神经在Dahl高血压小鼠模型中的作用进行验证,他们将实验模型分为假手术组(n=10),靶向肾交感神经消融组(肾脏去神经支配组, n=11),内脏神经消融组(腹腔神经节去除组,n=11),肾脏神经和腹腔神经联合消融组(n=11)。给予0.4%氯化钠饲料喂养3周后,平均动脉压由原来的约120mmHg(0.1%氯化钠饲料)增高至约140mmHg。此时,小鼠接受假手术及靶向的交感神经消融术。治疗四周后,与假手术组相比,肾脏去神经组(150.4±10.4)及腹腔神经去除组(147.0±6.1)小鼠平均动脉压降低,联合消融组的平均动脉压更低(128.4±6.6)。肾脏去神经组和假手术组的心率及体液平衡等方面无明显差异;但接受腹腔神经节去除组和联合消融组的小鼠表现为明显的心动过速和钠水储留。
研究数据显示对构建的Dahl鼠高血压模型来说靶向交感神经消融结果有效;在该模型中肾和内脏血管床均是交感神经独立且重要的作用靶点。

Abstract
The sympathetic nervous system plays an important role in some forms of human hypertension as well as the Dahl salt-sensitive rat model of hypertension; however, the sympathetic targets involved remain unclear. To address this, we examined the role of the renal and splanchnic sympathetic nerves in Dahl hypertension by performing sham surgery (n=10) or targeted sympathetic ablation of the renal nerves (renal denervation, n=11), the splanchnic nerves (celiac ganglionectomy, n=11), or both renal and splanchnic nerves (n=11) in hypertensive Dahl rats. Mean arterial pressure increased from ≈120 mm Hg, while on a 0.1% sodium chloride diet, to ≈140 mm Hg after being fed a 4.0% sodium chloride diet for 3 weeks. At that point, rats underwent sham or targeted sympathetic ablation. Four weeks after treatment, mean arterial pressure was lower in renal denervated (150.4±10.4) and celiac ganglionectomized (147.0±6.1) rats compared with sham rats (165.0±3.7) and even lower in rats that underwent both ablations (128.4±6.6). There were no differences in heart rate or fluid balance between sham and renal denervated rats; however, rats that underwent either celiac ganglionectomy or both ablations exhibited marked tachycardia as well as sodium and water retention after treatment. These data suggest that targeted sympathetic ablation is an effective treatment for established hypertension in the Dahl rat and that the kidneys and the splanchnic vascular bed are both independently important targets of the sympathetic nervous system in this model.

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    2013-09-24 feather89
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    2013-03-30 匿名用户

    靶向消融交感是研究热点,但是消融后患者远期生存质量有无变化?

    0

  7. 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