经颅及颈动脉制作神经源性高血压模型的比较研究

目的：比较经颅及经颈动脉制作神经源性高血压模型的效果。方法：选取24只杂种犬,随机分为两组（n=12）,一组通过颈动脉鞘内血管搏动压迫脱髓鞘的迷走神经制作成神经源性高血压模型,另外一组经颅通过小脑前下或后下动脉对迷走神经和舌咽神经的长期搏动性压迫造模。分别应用有创血压监测、酶联免疫吸附、放射免疫等技术检测术前及术后1周、2周、4周、8周、12周两组犬的血压,抽取静脉血检验肾素活性、血管紧张素II、醛固酮及肌酐等指标。结果：经两种不同方式造模后,在术后1周、2周、4周、8周、12周收缩压及舒张血压均明显高于造模前血压基础值,差异有统计学意义,两种造模方式造模后血压值未见明显差异。肾素活性、血管紧张素II及醛固酮水平随造模后时间的推移而增高（P〈0.05）,两组间各时间点无统计学差异（P〉0.05）。而经颅造模组术中出血量明显高于经颈动脉组,术后死亡率明显高于经颈动脉组。结论：经颅及经颈动脉造模均是有效的高血压造模方法,而经颈动脉高血压造模具有更简便易行、死亡率低、适宜大样本推广的特点。

A new model of neurogenic hypertension: transcarotid modeling

Objective: To compare the effect of neurogenic hypertension transcranial and transcarotid artery.Methods:24 dogs were randomly divided into two groups: transcarotid modeling group and transcranial modeling group.Renin activity(PRA),angiotensin II(Ang Ⅱ),aldosterone(Ald) and creatinine(Cr) were tested at preoperative and postoperative 1 week,2 weeks,4 weeks,8 weeks,12 weeks respectively.Results: After the surgery,systolic pressure and diastolic pressure of the two groups were significant higher than the basal blood pressure,but no difference was found between the two groups.The level of PRA,AngII and Ald increased after modeling(P<0.05),but no difference was found between the two groups.Compared with transcranial modeling group,the amount of bleeding intraoperation and mortality postoperation was significantly higher in transcarotid modeling group.Conclusion: Transcranial and transcarotid modeling are effective methods in neurogenic hypertension,but transcarotid modeling of neurogenic hypertension is more simple,with low mortality and more suitable for large sample extension.