肾动脉近段与全节段经皮去肾神经术1年血压随访结果  

Results of one-year blood pressure follow-up after proximal and total renal artery denervation

作　　者：任一文 周浩 陈伟杰[1,2] 杜华安[1,2] 张波[1,2] 李丹[1,2] 肖明阳 王子豪[1,2] 凌智瑜[1,2] 殷跃辉[1,2] REN Yi-wen;ZHOU Hao;CHEN Wei-jie;DU Hua-an;ZHANG Bo;LI Dan;XIAO Ming-yang;WANG Zi-hao;LING Zhi-yu;YIN Yue-hui(Department of Cardiology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400072,China;Cardiovascular Disease Neuromodulation Research and Therapy Center,Chongqing 400072,China)

机构地区：[1]重庆医科大学附属第二医院心血管内科,重庆400072 [2]重庆医科大学附属第二医院心血管疾病神经调控研究治疗中心,重庆400072

出　　处：《中国介入心脏病学杂志》2024年第6期305-310,共6页Chinese Journal of Interventional Cardiology

摘　　要：目的比较肾动脉近段与全节段经皮去肾神经术(RDN)在高血压患者中的降压效果是否存在差异。方法纳入2014年1月至2016年6月就诊于重庆医科大学附属第二医院的56例高血压患者,随机分为全节段消融组(25例)和近段消融组(31例)。收集所有患者术后6个月的24 h动态血压及术后12个月的诊室血压。结果两组患者血压均有明显下降,但两组降压效应之间差异无统计学意义(P>0.05)。全节段消融组与近段消融组基线诊室血压分别为(180±15)/(104±10)mmHg与(180±12)/(103±8)mmHg,在术后12个月时分别降低为(142±9)/(82±7)mmHg和(143±10)/(83±6)mmHg,治疗前后两组内诊室收缩压与舒张压显著降低,差异均有统计学意义(均P<0.001)。两组基线24 h动态血压分别为(162±13)/(95±8)mmHg与(160±12)/(94±8)mmHg,而术后6个月时分别降低为(142±11)/(83±7)mmHg和(141±8)/(81±7)mmHg,治疗前后两组内动态收缩压与舒张压亦显著降低,差异均有统计学意义(均P<0.001)。但两组间的诊室血压和动态血压的降幅差异均无统计学意义(均P>0.05)。未观察到与治疗相关的不良事件。结论全节段消融与近段消融这两种术式的降压获益相似。Objective To compare the efficacy of renal proximal renal artery denervation(pRDN)and full-length renal artery denervation(fRDN)for treatment of hypertension.Methods Fifty-six hypertensive patients were enrolled and randomly assigned to full-length renal artery denervation group(n=25)and proximal renal artery denervation group(n=31).After the procedure,24-hour ambulatory blood pressure monitoring(24 h-ABPM)at 6 months and office blood pressure at 12 months was recorded for statistical analysis.Results The blood pressure at follow-up reduced significantly in both groups,while there was no significant difference between groups.The baseline office blood pressure in fRDN group and pRDN group was(180±15)/(104±10)mmHg and(180±12)/(103±8)mmHg,respectively,which decreased to(142±9)/(82±7)mmHg and(143±10)/(83±6)mmHg at 12 months postoperatively(P<0.001 within groups and P>0.05 between groups).The baseline 24 h-ABPM in the two groups was(162±13)/(95±8)mmHg and(160±12)/(94±8)mmHg,respectively,which decreased to(142±11)/(83±7)mmHg and(141±8)/(81±7)mmHg at 6 months postoperatively(P<0.001 within groups and P>0.05 between groups).However,there was no significant difference in the reduction of office blood pressure and ambulatory blood pressure between the two groups.No treatment-related adverse events were observed.Conclusions pRDN has similar antihypertensive effect to fRDN.

关 键 词：经皮去肾神经术 高血压 全节段消融 近段消融 

分 类 号：R54[医药卫生—心血管疾病]