肾动脉内、外膜射频消融对比格犬肾动脉CD36和SR-A表达的影响
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(1.河南省人民医院心血管内科;2.阜外华中心血管病医院,河南省郑州市 450000)

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朱利杰,硕士研究生,主治医师,研究方向为冠心病的基础与临床研究,E-mail为zhulijie7788@163.com。通信作者高传玉,博士,主任医师,博士研究生导师,研究方向为冠心病的基础与临床研究,E-mail为gaocy6802@163.com。

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河南省科技攻关项目(172102310291);中国心血管健康联盟-心脏康复与代谢治疗基金(CCA-CRMT-1615)


Effect of renal artery radiofrequency ablation in endarterium or adventitia on the expression of CD36 and SR-A
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1.Department of Cardiology, Henan Provincial People's Hospital;2.Fuwai Center China Cardiovascular Hospital, Zhengzhou, Henan 450000, China)

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    摘要:

    目的 研究肾动脉内、外膜射频消融对肾动脉清道夫受体CD36和SR-A表达水平的影响,分析肾动脉射频消融导致肾动脉粥样硬化的潜在风险。方法 选取健康比格犬14只,雌雄各半,分为实验组(10只)和对照组(4只),实验组两侧肾动脉随机分为内膜组(10条动脉)和外膜组(10条动脉)。内膜组和外膜组均分为术后1个月组(5条动脉)和术后3个月组(5条动脉),对照组分为术后1个月组(4条动脉)和术后3个月组(4条动脉)。行肾动脉HE染色、免疫组织化学染色观察肾动脉的病理改变;通过Western blot检测肾动脉CD36和SR-A表达水平。结果 (1)肾动脉造影结果:术后1个月内膜组出现1例肾动脉明显狭窄,其余均未见肾动脉狭窄。(2)肾动脉病理改变:肾动脉射频消融后,HE染色可见肾动脉灼烧部位中膜平滑肌排列紊乱,内膜局部增厚,结构破坏;免疫组织化学结果可见肾动脉CD36表达聚集。对照组血管壁未见明显改变。(3)肾动脉CD36和SR-A表达:①术后1个月,内膜组(n=5)和外膜组(n=5)CD36和SR-A表达量明显多于对照组(n=4)(P均<0.001);内膜组(n=5)较外膜组(n=5)CD36和SR-A表达量增加,差异有显著性(P=0.040和P=0.007)。②术后3个月,内膜组(n=5)和外膜组(n=5)CD36和SR-A表达量明显高于对照组(n=4)(P均<0.001);而内膜组(n=5)较外膜组(n=5)CD36和SR-A表达量增加,差异有统计学意义(P均<0.001)。结论 肾动脉射频消融有导致肾动脉狭窄的可能,内膜消融可能更容易出现肾动脉狭窄;肾动脉内、外膜射频消融均有导致肾动脉粥样硬化的潜在风险。

    Abstract:

    Aim To study the effect of renal artery radiofrequency ablation in endarterium or adventitia on renal artery atherosclerosis by detecting expression levels of renal artery macrophage scavenger receptor (CD36 and SR-A). Methods 14 healthy beagles (7 male, 7 female) were randomly divided into experimental group (n=10) and control group (n=4), and two arteries in every beagle of the experimental group were randomly assigned to endarterium group(10 artery) and adventitial group(10 artery). At 1 month and 3 months follow-up, renal artery angiography was performed to observe the renal artery morphological change; HE staining and immunohistochemical staining were used to observe the renal artery pathological change; Western blot was used to detect the expression levels of renal artery macrophage scavenger receptor (CD36 and SR-A). Results (1) At 1 month follow-up, 1 case of obvious renal artery stenosis was found in endarterium group. (2) In the experimental group after renal denervation, intimal structure of renal artery was discontinued by HE staining, but no change was found in the control group; Immunohistochemistry showed the higher expression of CD36 in renal artery of experimental group. (3) The expression of scavenger receptors (CD36 and SR-A) in renal artery:①At 1 month follow-up, the expression levels of scavenger receptor CD36 and SR-A were significantly higher in endarterium group (n=5) and adventitia group (n=5) than that in the control group (n=4) (P<0.001); And the expression levels of scavenger receptor CD36 and SR-A were significantly higher in endarterium group (n=5) than that in adventitia group (P=0.040 and P=0.007); ②At 3 months follow-up, the expression levels of scavenger receptor CD36 and SR-A were significantly higher in endarterium group (n=5) and adventitia group (n=5) than that in control group (n=4) (P<0.001); And the expression levels of scavenger receptor CD36 and SR-A were significantly higher in endarterium group (n=5) than that in adventitia group (n=5) (P<0.001). Conclusion Renal artery stenosis may appear after renal denervation, and it was easier to lead to renal artery stenosis after renal denervation in endarterium;The structure of renal artery endarterium may be damaged (thickening and discontinuous) after renal denervation; and it is higher in endarterium, so it has the potential risk of renal atherosclerosis after renal denervation.

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朱利杰,高传玉,王宪沛,齐大屯,白民富,简冬冬,杨宏辉.肾动脉内、外膜射频消融对比格犬肾动脉CD36和SR-A表达的影响[J].中国动脉硬化杂志,2018,26(12):1227~1232.

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  • 收稿日期:2018-08-02
  • 最后修改日期:2018-10-27
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  • 在线发布日期: 2018-12-27