CAJ | 학술논문

目的探讨肾去交感神经(RSD)对肺动脉高压(PAH)模型犬肺血管重构的影响.方法 24只比格犬按随机数字表法随机均分为对照组、PAH组、PAH+ RSD组各8只.检测各组犬实验前血清神经激素水平、心脏超声和血流动力学参数后,对照组右心房注入二甲基甲酰胺(0.1 ml/kg),PAH组右心房注入脱氢野百合碱(2 ml/kg),PAH+ RSD组先行肾去交感神经术,后右心房注入脱氢野百合碱(2 ml/kg).喂养8周,检测各组犬实验后的血清神经激素水平、心脏超声和血流动力学参数后,开胸取肺组织检测肺血管形态学.结果实验后PAH组、PAH+ RSD组右心室收缩压(RVSP)和肺动脉收缩压(PASP)均显著高于对照组[(42.8±8.7)、(30.8±6.8)比(23.2±5.7) mmHg(1mmHg =0.133 kPa)和(45.1±11.2)、(32.6±7.9)比(24.7 ±7.1)mmHg],且PAH组RVSP和PASP显著高于PAH+ RSD组[均P＜0.01].实验后PAH组血清血管紧张素Ⅱ(AngⅡ)和内皮素1水平均显著高于实验前[(228 ±41)比(113±34) pg/ml和(135 ±15)比(77±7)pg/ml,均P＜0.01],且肺组织中AngⅡ和内皮素1水平[(65±10)和(96±10)pg/ml]均显著高于对照组[(38±7)和(54±6)pg/ml]和PAH+ RSD组[(46±8)和(67±9)pg/ml](均P＜0.01).与对照组相比,PAH组肺泡2型细胞破坏严重,组织纤维化明显,而PAH+ RSD组肺泡2型细胞破坏及组织纤维化较PAH组轻.结论 RSD可降低PAH模型犬肺动脉高压并抑制肺血管重构,此作用可能与其降低神经激素水平有关.
목적 탐토신거교감신경(RSD)대폐동맥고압(PAH)모형견폐혈관중구적영향.방법 24지비격견안수궤수자표법수궤균분위대조조、PAH조、PAH+ RSD조각8지.검측각조견실험전혈청신경격소수평、심장초성화혈류동역학삼수후,대조조우심방주입이갑기갑선알(0.1 ml/kg),PAH조우심방주입탈경야백합감(2 ml/kg),PAH+ RSD조선행신거교감신경술,후우심방주입탈경야백합감(2 ml/kg).위양8주,검측각조견실험후적혈청신경격소수평、심장초성화혈류동역학삼수후,개흉취폐조직검측폐혈관형태학.결과 실험후PAH조、PAH+ RSD조우심실수축압(RVSP)화폐동맥수축압(PASP)균현저고우대조조[(42.8±8.7)、(30.8±6.8)비(23.2±5.7) mmHg(1mmHg =0.133 kPa)화(45.1±11.2)、(32.6±7.9)비(24.7 ±7.1)mmHg],차PAH조RVSP화PASP현저고우PAH+ RSD조[균P＜0.01].실험후PAH조혈청혈관긴장소Ⅱ(AngⅡ)화내피소1수평균현저고우실험전[(228 ±41)비(113±34) pg/ml화(135 ±15)비(77±7)pg/ml,균P＜0.01],차폐조직중AngⅡ화내피소1수평[(65±10)화(96±10)pg/ml]균현저고우대조조[(38±7)화(54±6)pg/ml]화PAH+ RSD조[(46±8)화(67±9)pg/ml](균P＜0.01).여대조조상비,PAH조폐포2형세포파배엄중,조직섬유화명현,이PAH+ RSD조폐포2형세포파배급조직섬유화교PAH조경.결론 RSD가강저PAH모형견폐동맥고압병억제폐혈관중구,차작용가능여기강저신경격소수평유관.
Objective To explore the effects of renal sympathetic denervation (RSD) on pulmonary vascular remodeling in a model of pulmonary arterial hypertension (PAH).Methods According to the random number table,24 beagles were randomized into control,PAH and PAH + RSD groups (n =8 each).The levels of neurohormone,echocardiogram and dynamics parameters were measured.Then 0.1 ml/kg dimethylformamide (control group) or 2 mg/kg dehydromonocrotaline (PAH and PAH + RSD groups) were injected.The PAH + RSD group underwent RSD after injection.At week 8 post-injection,the neurohormone levels,echocardiogram,dynamics parameters and pulmonary tissue morphology were observed.Results The values of right ventricular systolic pressure (RVSP) and pulmonary arterial systolic pressure (PASP) in PAH and PAH + RSD groups were both significantly higher than those in control group ((42.8 ± 8.7),(30.8±6.8) vs (23.2±5.7) mmHg (1 mmHg=0.133 kPa) and (45.1 ±11.2),(32.6±7.9) vs (24.7 ±7.1) mmHg).Meanwhile,the values of RVSP and PASP in PAH group were higher than those in PAH + RSD group (all P ＜ 0.01).The levels of serum angiotensin Ⅱ (Ang Ⅱ) and endothelin-1 significantly increased after 8 weeks in PAH dogs ((228 ± 41) vs (113 ± 34) pg/ml and (135 ± 15) vs (77 ±7) pg/ml,all P ＜0.01).And Ang Ⅱ and endothelin-1 were higher in lung tissues of PAH group ((65 ± 10)and (96 ± 10) pg/ml) than in those of control group ((38 ± 7) and (54 ± 6) pg/ml) and PAH + RSD group ((46 ± 8) and (67 ± 9) pg/ml) (all P ＜ 0.01).Pulmonary tissues had marked collagen hyperplasia and lamellar corpuscles of type 2 alveolar cells were damaged more severely in PAH dogs than in PAH + RSD dogs.Conclusions RSD suppresses pulmonary vascular remodeling and decreases pulmonary arterial pressure in experimental PAH.And the effect of RSD on PAH may contribute to decreased neurohormone levels.