本文選題：高血壓 + 腎動(dòng)脈射頻消融��； 參考：《蘇州大學(xué)》2016年碩士論文

【摘要】：目的:通過(guò)手術(shù)方法建立神經(jīng)源性高血壓比格犬模型;觀察經(jīng)腹腎動(dòng)脈外膜射頻消融去神經(jīng)術(shù)對(duì)比格犬血壓的影響,并初步評(píng)估其有效性與安全性。方法:10只比格犬隨機(jī)分為兩組(干預(yù)組6只、對(duì)照組4只),均通過(guò)經(jīng)頸動(dòng)脈方式制作成神經(jīng)源性高血壓模型,監(jiān)測(cè)建模術(shù)后血壓及腎交感活性物質(zhì)變化。建模成功后,干預(yù)組犬在經(jīng)腹手術(shù)下行腎動(dòng)脈外膜射頻消融去神經(jīng)化治療,對(duì)照組僅進(jìn)行假手術(shù)操作。于術(shù)后2、4、6、8周監(jiān)測(cè)血壓變化情況,同時(shí)檢測(cè)術(shù)前及術(shù)后腎功能、腎交感活性物質(zhì)變化。術(shù)后8周時(shí),各實(shí)驗(yàn)犬行雙側(cè)腎動(dòng)脈造影觀察有無(wú)異常,處死實(shí)驗(yàn)犬,行腎及腎動(dòng)脈病理檢查。結(jié)果:建模后兩組犬血壓均升高明顯,干預(yù)組平均動(dòng)脈壓從術(shù)前(108.64±5.52)mm Hg升至術(shù)后(126.09±8.84)mm Hg(P0.001),腎素活性、血管緊張素Ⅱ水平同時(shí)升高(P0.001);經(jīng)腹腎動(dòng)脈射頻消融去神經(jīng)術(shù)后,平均動(dòng)脈壓2、4、6、8周分別降至(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),同時(shí)腎素活性、血管緊張素Ⅱ水平亦表現(xiàn)出相同下降趨勢(shì)(P0.001),肌酐等腎功能指標(biāo)無(wú)明顯變化(P0.05)。假手術(shù)后對(duì)照組比格犬血壓無(wú)明顯下降,腎素活性、血管緊張素Ⅱ仍維持在較高水平,其他各項(xiàng)指標(biāo)均無(wú)明顯變化。術(shù)后8周腎動(dòng)脈造影未見腎動(dòng)脈狹窄、夾層等并發(fā)癥。病理檢查示干預(yù)組犬腎動(dòng)脈交感神經(jīng)束周圍的纖維結(jié)締組織增厚,外形完整,無(wú)損傷、撕裂和夾層等,未見腎臟萎縮、壞死等病變。結(jié)論:經(jīng)腹腎動(dòng)脈外膜射頻消融去神經(jīng)術(shù)能夠?qū)Ρ雀袢a(chǎn)生顯著且持久的血壓下降作用,并降低血液中腎交感活性物質(zhì),對(duì)腎臟的形態(tài)與功能均無(wú)明顯影響。
[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 鹵5.52)mm Hg to 126.09 鹵8.84)mm Hg P 0.001a, the level of renin activity and angiotensin 鈪，

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