经皮肾动脉交感神经射频消融术治疗顽固性高血压的荟萃分析  

The effect of renal sympathetic nervous denervation on resistant hypertension:a systematic review

作　　者：金厦 谢晓林[1] 刘路平[1] 马静[1] JIN Sha;XIE Xiaolin;LIU Luping(Department of cardiovascular,the Third People＇s Hospital of Hangzhou,Hangzhou 310009,China)

机构地区：[1]杭州市第三人民医院心血管内科,310009

出　　处：《心电与循环》2018年第5期332-337,共6页Journal of Electrocardiology and Circulation

摘　　要：目的评价经皮肾动脉交感神经射频消融术(RDN)治疗顽固性高血压的疗效。方法检索PubMed、Cochrane Library、EMBASE、知网、万方等数据库,收集截止至2017年5月1日RDN治疗顽固性高血压的随机对照临床研究(RCT)。经严格筛选,用RevMan5.3进行荟萃分析。结果最终纳入7项RCT,共985例患者。荟萃分析结果显示:术后6个月RDN组和对照组诊室收缩压、舒张压下降差异均无统计学意义,95%CI分别为-16.26～6.40(P=0.39),-12.21～1.97(P=0.16)。RDN组24h动态血压收缩压、舒张压均较对照组下降,95%CI分别为-4.76～-0.81(P=0.006),-3.42～-0.28(P=0.02)。术后6个月eGFR下降值两组间比较无统计学差异(95%CI:-1.04～2.01,P=0.53)。结论对顽固性高血压患者,RDN不能降低诊室血压,但能降低24h动态血压,且安全性好。Objective To evaluate the blood pressure （BP） -lowering effect of renal sympathetic nervous denervation（RDN）in patients with resistant hypertension. Methods Randomized clinical trials about the effect of RDN on resistanthypertension,which published before May 2017 were searched based on PubMed,Cochrane Library,EMBASE,theChina Full Text Jounal database and Wanfang database and then evaluated strictly.Meta-analysis was performed usingRevMan5.3. Results Seven randomized clinical trials including 985 cases were enrolled finally. Meta-analysis showedthat the decrease of systolic and diastolic BP in office room was not significantly different between RDN group and controlgroup （95% confidence interval,-16.26~6.40/-12.21~1.97）,while 24h ambulatory systolic and diastolic BP wassignificantly lower in RDN group than control group（95% confidence interval,-4.76^-0.81/-3.42^-0.28, P〈0.05 for all） 6months after RDN. The decrement of eGFR was similar between the two groups at 6 months. Conclusion RDN mayreduce 24 h ambulatory BP rather than office BP in patients with resistant hypertension and is safety.

关 键 词：荟萃分析 肾动脉交感神经射频消融术 顽固性高血压 随机对照临床研究 

分 类 号：R544.1[医药卫生—心血管疾病]