摘要：
目的 探讨比格犬应用多电极消融系统行血管内去神经术的可行性及安全性.方法 18只体质量(10.2±1.1) kg,雌雄不限的健康实验用比格犬随机分成三组.比格犬由东南大学医学院动物实验中心提供,实验动物许可证编号:SYXK(苏)2016-0013.分别为即刻处死组、长期随访组、假手术对照组,每组各6只.即刻处死组与长期随访组行血管内去神经术,即刻处死组手术完成后处死;长期随访组继续饲养3个月后处死;假手术对照组将消融导管置人腹主动脉腹腔干起始部而不进行消融,继续饲养3个月.分别检测术前、术后即刻、15、30、90 d血液学指标,并于术后当天及术后第60天进行腹主动脉CT血管成像(CTA)检查,术后90 d行DSA检查.处死实验犬后取腹主动脉标本切片、染色观察动脉壁及神经元细胞变化.结果 即刻处死组、长期随访组12只比格犬均完成血管内去神经术,无意外死亡.解剖后肉眼观察所有实验犬均未出现腹主动脉穿孔及周围组织坏死等情况.各组实验犬CTA及DSA均未见血管损伤.假手术对照组与长期随访组血液生化指标的差异均无统计学意义.术后3个月:白细胞:(12.5±1.5)×109/L比(13.2±0.7)×109/L,P=0.275;红细胞:(7.0±0.6)×109/L比(6.3±0.4)×109/L,P=0.089;总胆红素:(2.9±0.4)μmol/L比(3.0±0.6)μmol/L,P=0.681;丙氨酸转氨酶:(40±11) U/L比(37±6) U/L,P=0.168;天冬氨酸转氨酶:(51±11) U/L比(48±9) U/L,P=0.221;尿素氮:(7.2±1.2) mmol/L比(6.9±0.8)mmol/L,P=0.505;肌酐:(60±9) μmol/L比(59±9) μmol/L,P=0.81;凝血酶原时间:(7.2±0.7)s比(7.0±0.7)s,P=0.719.病理切片示即刻处死组、长期随访组实验犬均存在神经损伤,周围组织未见明确损伤;假手术对照组实验犬神经束结构完整,未见明显损伤.结论 血管内去神经术应用于比格犬是安全、可行的.%Objective To assess the feasibility and safety of endovascular denervation (EDN) with a multi-electrode radiofrequency ablation catheter on beagles.Methods A total of 18 beagles,(10.2±1.1) kg,of either gender,were provided by the Animal Center of Southeast University (SYXK (Su) 2016-0013).They were divided equally into three groups:the instant euthanizing group,the long-term follow-up group and the sham operation group.Beagles in the instant euthanizing group were euthanized immediately after EDN.Beagles in the long-term follow-up group were euthanized three months after EDN.Beagles in the sham operation group underwent sham operation and were euthanized three months later.Blood biochemistry was measured at baseline,and immediately,15 days,30 days and 90 days after the surgery.Computerized tomographic (CT) angiography was determined before the surgery and 60 days after the surgery.Digital subtraction angiography (DSA) was determined 90 days after the surgery.Histopathologic analyses were used to identify the changes of arterial wall and neuron cells.Results Beagles in the long-term follow-up group and the sham operation group all underwent EDN successfully without accidental death.No abdominal aortic perforation and peripheral tissue necrosis were found at Necropsy.No vascular injuries were found by CTA and DSA in each group.There was no statistical difference in hematological analyses,90 days after the surgery:white blood ce11:(12.5±1.5)×109/L vs (13.2±0.7)×109/L,P=0.275;red blood cell:(7.0±0.6)×109/L vs (6.3±0.4)× 109/L,P=0.089;total bilirubin:(2.9±0.4) μmol/L vs (3.0±0.6) μmol/L,P=0.681;glutamic-pyruvic transaminase:(40± 11) U/L vs (37±6) U/L,P=0.168;glutamic oxalocetie transaminase:(51±1 1) U/L vs (48±9) U/L,P=0.221;urea nitrogen:(7.2±1.2) mmol/L vs (6.9±0.8) mmol/L,P=0.505;creatinine:(60±9) μmol/L vs (59±9) μmol/L,P=0.81;prothrombin time:(7.2±0.7) s vs (7.0±0.7) s,P=0.719.Histopathological analyses showed that there were hypercellular appearance of nerve bundle and thickened perineurium in EDN groups,while normal perineurium around nerve bundle in the sham operation group.Conclusion EDN could be applied in beagles safely and feasibly.
