经脊髓电刺激房颤模型犬血清肾素-血管紧张素-醛固酮系统的变化及其对房颤的抑制作用

doi:10.13481/j.1671-587x.20190308

摘要/Abstract

摘要： 目的：探讨心房颤动（房颤）犬经脊髓电刺激（SCS）治疗后血清肾素-血管紧张素-醛固酮系统（RAAS）指标及房颤负荷的变化，阐明SCS对房颤的抑制作用及其对RAAS的影响。方法：选择24只健康成年犬，对其中16只植入起搏器及心电追踪器，采用右房快速起搏方式建立房颤犬模型，将建模成功的16只房颤模型犬分为房颤组（AF组，n=8）及SCS治疗组（SCS组，n=8），对SCS组犬植入脊髓刺激器并给予12周的SCS治疗；剩余犬作为空白对照组（n=8）。通过心电追踪器监测AF组和SCS组犬房颤负荷；以超声心动图测量3组犬左右心房面积； ELISA法检测各组犬血清肾素、血管紧张素Ⅱ（Ang Ⅱ）、醛固酮（ALD）、血管紧张素Ⅱ受体1（AT1R）、血管紧张素Ⅱ受体2（AT2R）和血管紧张素转化酶2（ACE2）水平。结果：SCS组犬房颤负荷较AF组明显降低（P<0.05）。AF组犬左、右心房面积均较空白对照组扩大（P<0.05）；SCS组犬左心房面积较AF组缩小（P<0.05），右心房面积亦缩小，但差异无统计学意义（P>0.05）；SCS组犬左、右心房面积较空白对照组扩大（P<0.05）。与空白对照组比较，AF组犬血清ACE2水平降低（P<0.05），肾素、Ang Ⅱ、ALD、AT1R和AT2R水平均升高（P<0.05）；与AF组比较，SCS组犬血清ACE2水平升高，肾素、Ang Ⅱ、ALD、AT1R和AT2R水平均降低（P<0.05）。与建模前比较，建模后AF组犬血清ACE2水平降低（P<0.05），肾素、Ang Ⅱ、ALD、AT1R和AT2R水平均升高（P<0.05）；与治疗前比较，治疗后SCS组犬血清ACE2水平升高（P<0.05），肾素、Ang Ⅱ、ALD、AT1R和AT2R水平均降低（P<0.05）。结论：房颤可激活RAAS，SCS治疗能抑制房颤并可抑制因房颤激活的RAAS，进而对房颤的恶化起到抑制作用。血清RAAS指标是评价SCS治疗房颤转归的重要观察指标。

关键词: 心房颤动, 脊髓电刺激, 犬, 肾素-血管紧张素-醛固酮系统

Abstract: Objective:To investigate the changes of the serum indexes of renin-angiotensin-aldosterone system(RAAS) and atrial fibrillation burden in the atrial fibrillation model dogs underwent spinal cord stimulation(SCS) therapy, and to illuminate the therapeutic effect of SCS on the atrial fibrillation and its effect on RAAS. Methods:A total of 24 healthy adult dogs were chosen.The pacemakers and miniaturized insertable cardiac monitors were implanted into 16 dogs to establish the atrial fibrillation models by rapid right atrial pacing. Then 16 model dogs were divided into atrial fibrillation (AF) group and SCS group(n=8). The spinal cord stimulators were implanted into the dogs in SCS group to release stimulation for 12 weeks. And the rest dogs were regareded as blank control group(n=8). The atrial fibrillation burden of dogs in AF group and SCS group was monitored by miniaturized insertable cardiac monitors;the left and right atrial areas of dogs in three groups were measured by echocardiography;the serum levels of renin, angiotensin Ⅱ(Ang Ⅱ), aldosterone(ALD), angiotensin Ⅱ type 1 receptor(AT1R), angiotensin Ⅱ type 2 receptor(AT2R) and angiotensin converting enzyme 2(ACE2) of the dogs in three groups were detected by ELISA method. Results:Compared with AF group,the atrial fibrillation burden of the dogs in SCS group was decresed obviously (P<0.05).The left and right atrial areas of dogs in AF group were larger than those in blank control group(P<0.05);the left atrial area of the dogs in SCS group was smaller than that in AF group (P<0.05),the right atrial area was also smaller,but there was no significant difference (P>0.05);the left and right atrial areas of the dogs in SCS group were larger than those in blank control group (P<0.05).The serum ACE2 level of dogs in AF group was lower than that in blank control group (P<0.05)and the levels of serum renin, Ang Ⅱ, ALD, AT1R and AT2R of the dogs in AF group were all higher than those in blank control group(P<0.05);the serum ACE2 level of the dogs in SCS group was higher than that in AF group(P<0.05)and the levels of serum renin, Ang Ⅱ, ALD, AT1R, and AT2R of the dogs in SCS group were all lower than those in AF group(P<0.05).Compared with before modeling,the serum ACE2 level of dogs in AF group after modeling was decresed(P<0.05),and the levels of serum renin, Ang Ⅱ, ALD, AT1R, and AT2R were incresed(P<0.05); compared with before treatment,the serum ACE2 level of the dogs in SCS group after treatment was incresed (P<0.05), and the levels of serum renin, Ang Ⅱ, ALD, AT1R, and AT2R were decresed (P<0.05). Conclusion:Atrial fibrillation can activate the RAAS. SCS therapy can suppress the atrial fibrillation and it can suppress RAAS activated by atrial fibrillation,so SCS can restraint the deterioration of atrial fibrillation.The serum RAAS indexes are so important observation indexes to evaluate the outcome of SCS in the treatment of atrial fibrillation.

Key words: atrial fibrillation, spinal cord stimulation, dog, renin-angiotensin-aldosterone system

中图分类号:

R541.75

师慧, 赵璐露, 杜云蕙, 华宝桐, 郭涛. 经脊髓电刺激房颤模型犬血清肾素-血管紧张素-醛固酮系统的变化及其对房颤的抑制作用[J]. 吉林大学学报(医学版), 2019, 45(03): 511-517.

SHI Hui, ZHAO Lulu, DU Yunhui, HUA Baotong, GUO Tao. Changes of RAAS in atrial fibrillation model dogs after spinal cord stimulation and its inhibitory effect on atrial fibrillation[J]. Journal of Jilin University(Medicine Edition), 2019, 45(03): 511-517.

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