肺静脉隔离术联合肾动脉去交感神经术临床治疗心房颤动meta分析  

Pulmonary vein isolation combined with renal artery denervation for the treatment of atrial fibrillation: a meta analysis

作　　者：吴美桦 郜俊清[1] WU Meihua;GAO Junqing(Department of Cardiology,Putuo District Central Hospital,Shanghai 200062,China)

机构地区：[1]上海市普陀区中心医院心内科,200062 [2]成都中医药大学

出　　处：《介入放射学杂志》2021年第1期9-13,共5页Journal of Interventional Radiology

基　　金：上海市卫生健康委卫生行业临床研究专项项目(201840247);上海市普陀区卫生健康系统临床医学优势学科建设项目(2019ysxk01)。

摘　　要：目的评价肺静脉隔离术(PVI)联合肾动脉去交感神经术(RDN)治疗心房颤动(房颤)的有效性。方法计算机检索Pubmed、Cochrane Library、中国学术期刊(CNKI)、万方和维普等数据库2009年1月至2020年2月收录的PVI联合RDN治疗房颤的临床随机对照研究文献。采用RevMan 5.3软件进行meta分析。结果纳入6篇临床随机对照试验研究文献共654例患者。Meta分析结果显示,术后12个月接受PVI联合RDN治疗组房颤患者房颤复发风险与单纯PVI治疗组(对照组)相比显著降低(OR=0.40,95%CI=0.29~0.56,P<0.000 1);诊室血压平均收缩压与对照组相比降低12.21 mm Hg(1 mmHg=0.133 kPa,95%CI=-12.22~-12.21,P<0.000 1),平均舒张压降低8.84 mmHg(95%CI=-8.84~-8.83,P<0.000 1);动态血压平均收缩压与对照组相比下降3.37 mmHg(95%CI=-3.38~-3.35,P<0.000 1),平均舒张压降低1.38 mmHg(95%CI=-1.40~-1.37,P<0.000 1)。结论 PVI联合RDN治疗房颤患者与单纯PVI治疗相比,有更低的房颤复发率,且可降低患者血压。Objective To evaluate the efficacy of pulmonary vein isolation(PVI) combined with renal artery denervation(RDN) in the treatment of atrial fibrillation. Methods Computerized retrieval of randomized controlled trial(RCT) papers concerning PVI combined with RDN for the treatment of patients with atrial fibrillation from the databases of Pubmed,Cochrane Library,Chinese Academic Journals(CNKI),Wanfang and VIP documented in the period from January 2009 to February 2020 was conducted. RevMan 5.3 software was used to make meta analysis. Results A total of 6 RCT papers including 654 patients were enrolled in this study. Meta analysis showed that 12 months after treatment the recurrence risk of atrial fibrillation in the study group(receiving PVI together with RDN) was significantly lower than that in the control group(receiving PVI alone)(OR =0.40;95% CI =0.29-0.56,P <0.0001). When compared with the control group,in the study group the mean clinic-room systolic blood pressure was decreased by 12.21 mmHg(95%CI=-12.22 to-12.21,P<0.0001),the mean clinic-room diastolic blood pressure was decreased by 8.84 mmHg(95%CI=-8.84 to-8.83,P<0.0001),the mean dynamic systolic blood pressure was decreased by 3.37 mm Hg(95%CI=-3.38 to-3.35,P<0.0001),and the mean dynamic diastolic blood pressure was decreased by 1.38 mm Hg(95%CI=-1.40 to-1.37,P <0.0001). Conclusion Compared with simple PVI treatment,PVI together with RDN therapy carries obviously lower recurrence rate and can reduce blood pressure in patients with atrial fibrillation.(J Intervent Radiol,2021,30: 9-13)

关 键 词：心房颤动 复发 肺静脉隔离术 肾动脉去交感神经术 

分 类 号：R541.7[医药卫生—心血管疾病]