双侧颈上交感神经节阻断延缓主动脉夹层病理过程的机制

doi:10.3785/j.issn.1008-9292.2019.10.10

浙江大学学报（医学版）

2019, Vol. 48

Issue (5): 526-532 DOI: 10.3785/j.issn.1008-9292.2019.10.10

原著

双侧颈上交感神经节阻断延缓主动脉夹层病理过程的机制

张政军¹(

),王虎^2,*(

),张玉京³,苏金林²,李建军²

1. 宁夏医科大学总医院心内科, 宁夏银川 750000
2. 宁夏医科大学总医院胸心外科, 宁夏银川 750000
3. 宁夏医科大学总医院心脏及大血管外科, 宁夏银川 750000

Effect of bilateral superior cervical sympathetic ganglion occlusion on pathological process of aortic dissection and its mechanism

ZHANG Zhenjun¹(

),WANG Hu^2,*(

),ZHANG Yujing³,SU Jinlin²,LI Jianjun²

1. Department of Cardiology, General Hospital of Ningxia Medical University, Yinchuan 750000, China
2. Department of Cardiothoracic Surgery, General Hospital of Ningxia Medical University, Yinchuan 750000, China
3. Department of Cardiac and Vascular Surgery, General Hospital of Ningxia Medical University, Yinchuan 750000, China

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摘要：

目的: 探讨双侧颈上交感神经节阻断对主动脉夹层病理过程的影响及机制。方法: 将45只SD大鼠随机分为空白对照组、手术对照组、交感阻断组。采用β-氨基丙腈建立主动脉夹层模型，交感阻断组注射β-氨基丙腈前接受颈上交感神经节阻断术。采用无创尾动脉血压监测大鼠的血压和心率，药物阻滞法间接监测交感神经活性，HE染色观察主动脉壁组织结构，天狼星红染色观察胶原纤维增殖，免疫组织化学法检测Apelin蛋白表达，蛋白免疫印迹法检测基质金属蛋白酶（MMP）-2、9蛋白表达。结果: 实验期间，手术对照组和交感阻断组体质量小于空白对照组（均P < 0.05），且交感阻断组体质量大于手术对照组（均P < 0.05）。手术对照组的心率和交感神经活性较空白对照组增加（均P < 0.05），而交感阻断组降低（均P < 0.05）。与空白对照组比较，手术对照组主动脉管壁增厚，而交感阻断组主动脉管壁增厚情况较手术对照组有所改善。空白对照组主动脉血管壁中大量胶原蛋白-1被天狼星红染成褐色，交感阻断组次之，手术对照组胶原蛋白-1染色最浅。与空白对照组比较，手术对照组Apelin、MMP-2、MMP-9蛋白表达增加（均P < 0.05），而交感阻断组Apelin、MMP-2、MMP-9蛋白表达较手术对照组减少（均P < 0.05）。结论: 颈上交感神经节阻断术可有效减少诱导大鼠主动脉夹层的发生及死亡，可能与抑制交感神经活性，减少胶原蛋白1、Apelin、MMP-2、MMP-9蛋白表达有关。

关键词： 动脉瘤, 夹层/病理学; 主动脉疾病/病理学; 交感神经系统; 颈上神经节; 脂肪类/代谢; 基质金属蛋白酶类; 随机对照试验

Abstract:

Objective: To investigate the effect of bilateral superior cervical sympathetic ganglion occlusion (SCG) on aortic dissection and its possible mechanism. Methods: Forty-five SD rats were randomly divided into three groups with 15 in each:blank control group, sham operation group and SCG group. β-aminopropione (666 mg·kg^-1·d^-1) was given by subcutaneous injection for 4 weeks to establish the aortic dissection model. Rats in SCG group were given SCG before the injection of β-aminopropione. Blood pressure and heart rate of the rats were monitored using noninvasive tail artery blood pressure measuring instrument; sympathetic activity was monitored using drug block method; the structure of aortic wall was observed using HE staining; collagen fibers in aortic wall was observed using Sirius red staining; protein expression of Apelin was detected by immunohistochemistry; and the protein expression of matrix metalloproteinase (MMP)-2, 9 was detected by Western blotting. Results: During the experiment, the body mass of the sham operation group and SCG group was smaller than that of the blank control group (all P < 0.05), and the body mass of the SCG group was larger than that of the sham operation group (all P < 0.05). The heart rate and sympathetic activity of the sham operation group were higher than those of the blank control group (all P < 0.05), while the SCG group were lower (all P < 0.05). Compared with the blank control group, the aortic wall in the sham operation group was thickening, while that in the SCG group was improved. A large number of collagen-1 in the aortic wall of the blank control group was stained brown by Sirius red, which was lighter in SCG group, and the staining in the sham operation group was the lightest. Compared with the blank control group, the expression of Apelin, MMP-2 and MMP-9 protein in the sham operation group increased (all P < 0.05), while those in the SCG group decreased (all P < 0.05). Conclusion: SCG can effectively reduce the incidence and mortality of aortic dissection in rats, which may be related to the inhibition of sympathetic activity and the decrease of collagen-1, Apelin, MMP-2 and MMP-9 expression.

Key words: Aneurysm, dissecting/pathology Aortic diseases/pathology Sympathetic nervous system Superior cervical ganglion Fats/metabolism Matrix metalloproteinases Randomized controlled trial

收稿日期: 2019-04-30 出版日期: 2020-01-04

R361+.1

通讯作者: 王虎 E-mail: 601948902@qq.com;wangfirstday@163.com

作者简介: 张政军(1975-), 男, 硕士, 主治医师, 主要从事冠心病治疗研究; E-mail:601948902@qq.com; https://orcid.org/0000-0002-4957-3403

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引用本文:

张政军,王虎,张玉京,苏金林,李建军. 双侧颈上交感神经节阻断延缓主动脉夹层病理过程的机制[J]. 浙江大学学报（医学版）, 2019, 48(5): 526-532.

ZHANG Zhenjun,WANG Hu,ZHANG Yujing,SU Jinlin,LI Jianjun. Effect of bilateral superior cervical sympathetic ganglion occlusion on pathological process of aortic dissection and its mechanism. J Zhejiang Univ (Med Sci), 2019, 48(5): 526-532.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2019.10.10 或 http://www.zjujournals.com/med/CN/Y2019/V48/I5/526

图 1 三组动脉血管壁组织结构变化(HE染色)

图 2 实验期间三组大鼠体质量变化

表 1 三组血压、心率及交感神经活性比较

图 3 三组主动脉血管壁厚度和胶原蛋白1含量比较

图 4 三组主动脉中Apelin蛋白表达

图 5 三组主动脉中MMP-2、MMP-9蛋白电泳图

表 2 三组主动脉中MMP-2、MMP-9蛋白相对表达量比较

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