高强度聚焦超声治疗难治性高血压的安全性和可行性研究  

Safety and feasibility of high intensity focused ultrasound in the treatment of resistant hypertension

作　　者：蒲铀 周崑[2] 金成兵[2] 陈星 容顺康[3] 黄晶[3] 朱辉[2] Pu You;Zhou Kun;Jin Chengbin;Chen Xing;Rong Shunkang;Huang Jing;Zhu Hui(State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University;Clinical Center for Tumor Therapy, the Second Affiliated Hospital of Chongqing Medical University;Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University)

机构地区：[1]重庆医科大学生物医学工程学院、省部共建国家重点实验室培育基地一重庆市超声医学工程重点实验室、重庆市生物医学工程学重点实验室,重庆400016 [2]重庆医科大学附属第二医院肿瘤中心,重庆400010 [3]重庆医科大学附属第二医院心血管内科,重庆400010

出　　处：《重庆医科大学学报》2018年第3期382-387,共6页Journal of Chongqing Medical University

基　　金：国家重点基础研究发展计划(973计划)资助项目(编号：2011CB707900).

摘　　要：目的:评价高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗难治性高血压(resistant hypertension,RH)的安全性和可行性。方法:对40例RH患者行HIFU去肾交感神经术治疗,治疗后随访患者6个月,评估术中及术后不良反应及并发症情况,术后血压下降效果、降压药物种类、肾动脉收缩期流速峰值和肾功能情况。结果:(1)40例患者均完成手术,治疗中主要不适为治疗区疼痛,一般在术后24 h内缓解。术后不良反应均在SIR-A^B级,无一例SIR-C^F级不良反应发生。(2)术后患者左、右肾动脉收缩期流速峰值较术前无差异(P=0.635,P=0.688)。术后患者随访1、6个月血尿素氮、血肌酐、肾小球滤过率较基线无统计学差异(P=0.772,P=0.652,P=0.366)。(3)术后随访1、3、6个月较基线诊室收缩压下降21.5、23.3、22.4 mm Hg(P=0.000),诊室舒张压下降11.1、12.9、12 mm Hg(P=0.000);24 h动态收缩压下降13.6、15.2、14.3 mm Hg(P=0.000),24 h动态收缩压下降5.5、6、4.4 mm Hg(P=0.000);药物种类下降0.8、0.9、1.0种(P=0.000)。结论:HIFU近期治疗RH是安全和可行的,但仍需深入及长期安全性、有效性探索。Objective：To evaluate the safety and feasibility of high intensity focused ultrasound （HIFU） in the treatment of resistant hypertension. Methods：Totally 40 patients with resistant hypertension underwent the treatment of high intensity focused ultrasound were enrolled. Intraoperative and postoperative adverse effects were recorded;the drop of blood pressure,types of drug used, peak systolic velocity of renal artery and renal function were followed up to 6 months post treatment. Results： （~）All patients completed HIFU treatment successfully. The major discomforts that patients complained during the procedure was pain in the treatment area,which usually disappeared within 24 hours. Base on the SIR classification, most of adverse effects were classified as A to B ; no C to F was found. （2）Preoperative and postoperative peak systolic velocity of left and right renal artery had no statistic difference （P=0.635 ,P=0.688）. The comparison between baseline and 1,6 months of blood urea nitrogen,serum creatinine and glomerular filtration rate had no statistic difference（P=-0.772,P=0.652,P=-0.366）. （3） The systolic blood pressure dropped 21.5,23.3,22.4 mmHg（P= 0.000） ,diastolic blood pressure dropped 11.1,12.9,12 mmHg （P=0.000）. 2d-hour systolic blood pressure dropped 13.6,15.2, 14.3 mmHg（P=0.000）, 2d-hour diastolic blood pressure dropped 5.5,6,4.4 mmHg（P=0.000） ;and types of drug dropped 0.8,0.9,1.0（P=0.000） in the later 1,3,6 months. Conclusion ： HIFU is safe and feasible in thd treatment of resistant hypertension. However,further study about long-term safety and efficacy of HIFU is still needed.

关 键 词：高强度聚焦超声 难治性高血压 安全性 可行性 

分 类 号：R544.1[医药卫生—心血管疾病]