去肾神经术治疗高血压的临床前景和探索方向

Future of Renal Denervation on Hypertension Therapy

许多随机临床试验显示经皮去肾神经术(RDN)具有降压的安全性和有效性,但目前其降压幅度有限,个体对治疗应答率不够高,尚缺乏改善高血压患者预后的直接证据,对治疗反应性的预测和术后即刻疗效的判定等方面手段有限,这些问题对临床应用构成巨大挑战。不同RDN消融手段间疗效比较、介入入路选择、器械性能改进及临床成本效益等也需进一步阐明。现就RDN治疗高血压的临床应用前景及进一步探索方向进行探讨。

Previous randomized clinical trials have demonstrated the safety and efficacy of renal denervation(RDN)in treating hypertension.However,the extent of blood pressure reduction is currently limited,and the individual response rate to treatment is not high enough.There is a lack of direct evidence to improve the clinical outcome prognosis among hypertension patients.The prediction of treatment response and the determination of immediate postoperative efficacy are also limited,posing significant challenges in clinical application.The comparison of therapeutic effects between different RDN ablation methods,the choice of interventional access,the improvement of device performance,and the clarification of clinical cost-effectiveness also require further elucidation.This review will explore the prospects of clinical application of RDN in the treatment of hypertension and the direction for further exploration.