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顽固性高血压患者经皮去肾动脉交感神经支配术疗效观察

罗迪1,王丽1,夏大胜2,陈欣2,赵向东3,于翔4,徐建强5,卢成志4   

  1. 1. 天津医科大学
    2. 第一中心医院心内科
    3. 天津市一中心医院
    4. 天津市第一中心医院
    5. 一中心
  • 收稿日期:2012-04-28 修回日期:2012-10-17 出版日期:2013-02-15 发布日期:2013-02-15
  • 通讯作者: 罗迪

Renal Sympathetic Denervation Follow-up at 6 Months

  • Received:2012-04-28 Revised:2012-10-17 Published:2013-02-15 Online:2013-02-15
  • Contact: LUO Di

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摘要：

【摘要】目的 分析11例顽固性高血压病患者行经皮去肾动脉交感神经支配术(RSD)后随访6个月血压变化和肾功能情况，评价手术有效性及安全性。方法 收集11例RSD手术患者的入院基线至术后随访6个月的临床资料，对血压水平、肾功能指标采用重复测量方差分析进行对比分析。结果 RSD术后随访6个月诊室坐位收缩压/舒张压由基线（191.8±30.3）mm Hg/(101.7±12.2）mm Hg降至（144.1±14.0）mm Hg/（83.7±6.8）mm Hg，RSD治疗前后相比收缩压和舒张压差异均有统计学意义（F 分别为24.039和14.007，均P < 0.01），术前6例静脉应用降压药物患者，于RSD术后均可停用，术后6个月随访平均用药种类较术前显著减少（t=9.587，P＜0.001）。肾功能指标Scr、UA、eGFR等较术前差异无统计学意义，BUN于术后3 d较术前略升高，至术后6个月与基线差异无统计学意义。泌尿系超声、肾动脉CTA 未见明显肾脏形态改变，无新发肾动脉狭窄。结论 RSD术后随访6个月可见收缩压/舒张压仍维持在较低水平，未见新发肾功能损害，表明RSD治疗顽固性高血压病安全、有效。

关键词: 顽固性高血压病, 血压, 去肾动脉交感神经支配术, 治疗, 肾小球滤过率

Abstract: Abstract Objective: To evaluate the safety and efficacy of Renal sympathetic denervation in resistant hypertension through analyzing patient’s blood pressure and renal function at six months. Methods: Follow up 11 cases at baseline, 3 days after the surgery, and six months. To analysis their clinical characteristics including risk factors, BP level, renal function and compared with the baseline. Result: Compared to baseline, the systolic and Diastolic blood pressure were significently lower at intraoperative than baseline, and the BP remain low level in 6 months after surgery, P＜0.001. Conclusions: Effects of renal sympathetic denervation on blood pressure is notable, and safety which proved by follow-up. The findings provide new insights into mechanisms of disease, and show a way for the growing worldwide population of resistant hypertension.

Key words: resistant hypertension, blood pressure, renal sympathetic denervation, therapy, eGFR