经皮肾动脉去交感神经治疗中重度心力衰竭的临床观察  

Percutaneous renal artery sympathetic denervation improves cardiac functions in patients with chronic heart failure

作　　者：郜俊清[1] 杨伟[1] 刘宗军[1] 

机构地区：[1]上海市普陀区中心医院心内科,上海200062

出　　处：《临床心血管病杂志》2015年第11期1211-1214,共4页Journal of Clinical Cardiology

基　　金：国家自然科学基金青年项目资助(No:81303145);上海市卫计委重点项目(No:20134003);上海市卫计委面上项目;上海市卫计委医学重点专科建设项目(No:ZK2012B05)

摘　　要：目的:确定经皮肾动脉去交感神经术对慢性心力衰竭(心衰)患者心功能的改善作用。方法:8例患者皆诊断为慢性心衰,都进行了双侧肾动脉去神经治疗。我们对8例患者术前及随访6个月的心脏不良事件、心功能、6分钟步行试验、血压及生化检测进行了比较。结果:8例患者在进行RDN术后及6个月随访期间,除了有1例患者发生急性脑梗死以外,无一例出现与RDN手术相关的并发症。6个月随访,患者收缩压从(137.5±30.1)mmHg(1mmHg=0.133kPa),下降到(120.7±13.0)mmHg(P=0.196),舒张压从(84.4±10.8)mmHg下降到(74.3±6.7)mmHg(P=0.053),肌酐从(123.25±65.4)μmol/L上升到(124.7±56.2)μmol/L(P=0.964)。6分钟步行试验距离从术前(181.25±20.31)m提升至6个月(401.43±82.35)m,具有统计学差异(P<0.001)。射血分数从术前(35.1±5.4)%上升到(47.0±10.3)%(P=0.014)。结论:RDN可能是一种有效治疗重度心衰的新技术,可有效提高射血分数,并可提高患者运动耐量,减少心衰的急性发生。Objective：To explore the effect of percutaneous renal artery sympathetic denervation in improving cardiac function in patients with chronic heart failure.Method：Eight patients were diagnosed as chronic heart failure,and have conducted bilateral renal artery denervation.We studied 8 patients before operation and during the follow-up period（6 months）in adverse cardiac events,cardiac function,the 6 minute walk test,blood and biochemical test.Result：There was on patient appeared RDN operation complications,and 6 months follow-up only one patient occur acute cerebral infarction.The 6 months follow-up,patients with systolic blood pressure decreased from（137.5±30.1）mmHg to（120.7±13.0）mmHg（P=0.196）,diastolic blood pressure decreased from（84.4±10.8）mmHg to（74.3±6.7）mmHg（P=0.053）,creatinine increased from（123.25±65.4）μmol/L to（124.7±56.2）μmol/L（P=0.964）.The 6 minute walk test distance from preoperative（181.25±20.31）meters up to 6 months（401.43±82.35）meters,with statistical difference（P〈0.001）.The EF from preoperative（35.1±5.4）% rise to（47.0±10.3）%（P=0.014）.Conclusion：RDN may be a new technology of effective treatment for severe heart failure,which can effectively improve the EF,improve the tolerance of patients with movement,and reduce heart failure of acute occurrence.

关 键 词：肾去神经化 交感神经系统 心力衰竭 血压 

分 类 号：R541.6[医药卫生—心血管疾病]