环状电极电刺激标测犬肾动脉周围神经分布

The electrical stimulation with annular electrode catheter maps the nerve distribution around renal artery in dogs

目的探讨环状电极电刺激后血压反应与犬肾动脉周围神经分布之间的关系。方法随机纳入8只昆明犬,经肾动脉造影排除血管畸形,使用环状电极对双侧肾动脉近、中、远段分别进行分区域高频电刺激(HFS,频率20Hz,电压8V,脉宽2ms,持续时间1min),将电刺激有反应的区域(持续高频电刺激后收缩压上升≥10mm Hg)纳入高频电刺激阳性反应组(HFSP组,n=25),电刺激无反应的区域纳入高频电刺激阴性反应组(HFSN组,n=119)。对血压及组织病理学进行分析。结果与基线比较,HFSP组刺激后收缩压和舒张压分别升高(13.4±4.1)和(9.9±4.9)mm Hg(均P<0.01),HFSN组刺激后收缩压和舒张压分别升高(1.4±3.7)和(1.3±2.5)mm Hg(均P>0.05)。对犬肾动脉周围神经分布进行测量分析,HFSP组的平均神经面积和平均神经数量高于HFSN组[(0.41±0.19)比(0.18±0.06)mm^2,(7.16±3.94)比(3.48±2.23)根,均P<0.01]。结论环状电极电刺激能够有效标测肾动脉周围神经分布,进一步为选择性肾动脉交感神经消融提供了理论依据。

Objective To investigate the canine nerve distribution around renal artery by the high-frequency electrical stimulation （HFS） with annular electrode catheter. Methods A total of 8 Kunming dogs were randomly included. Renal artery abnormalities were excluded by angiography. The subregional electrical stimulation （frequency 20 Hz, voltage 8 V, pulse width 2 ms, duration 1 min） were performed with annular electrode catheter from proximal to dis tal renal artery in all dogs. HFS positive areas （systolic blood pressure increased at least 10 mm Hg after sustained HFS） were allocated to HFS positive （HFSP） group （n= 25） and the other negative areas were assigned to HFS negative （HFSN） group （n=119）. Blood pressure and histopathology were analyzed. Results In HFSP group, stimulation caused significant increases of （13.4±4.1） mm Hg in systolic blood pressure and （9.9±4.9） mm Hg in diastolic blood pressure compared with baseline blood pressure （both P〈0.01}. Whereas in HFSN group, stimu lation only increased systolic and diastolic blood pressure by （1.4±3.7） and （1.3±2.5） mm Hg respectively （both P〉0.05）. The mean area and average number of nerves in HFSP group were significantly higher than those in HFSN group [mean area： （0.41±0.19） vs （0.18±0.06）mm2, average number： 7.16±3.94 vs 3.48±2.23, both P〈0.01]. Conclusion The electrical stimulation with the annular electrode can effectively maps the nerve distri- bution around renal artery, which provides a theoretical basis for the selective renal artery sympathetic nerve ablation.