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经皮经导管去肾神经术治疗难治性高血压的临床规范

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摘要 难治性高血压是指在改善生活方式基础上,同时使用足量的3种不同机制降压药（包含至少1种利尿剂）时,血压仍不能达标,或血压虽能达标,但要服用4种以上降压药的特殊类型高血压[1].经皮经导管去肾神经术（RDN）基本原理是通过插入肾动脉的射频导管释放能量,透过肾动脉的内、中膜,选择性损毁外膜的肾交感神经纤维,从而达到降低肾交感神经活性,阻断交感神经过度兴奋在高血压维持和恶化过程中的重要作用,为难治性高血压患者治疗提供了新的方法[2-4].2012年12月,美国心脏学会（AHA）联合美国脑卒中学会（ASA）公布了2012 年心脏病和脑卒中研究领域的十大进展,＂RDN治疗顽固性高血压＂名列其中.
作者 蒋雄京 董徽
机构地区 中国医学科学院
出处 《临床内科杂志》 CAS 2014年第1期10-12,共3页 Journal of Clinical Internal Medicine
关键词 经皮经导管去肾神经术 顽固性高血压 临床规范
分类号 R544.1 [医药卫生—心血管疾病]
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参考文献16

  • 1Calhoun DA,Jones D,Textor S,et al.Resistant hypertension:diagnosis,evaluation and treatment.A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research[J].Hypertension,2008,51(6):1403-1419.
  • 2Krum H,Schlaich M,Whitbourn R,et al.Catheter-based renal sympathetic denervation for resistant hypertension:a multicentre safety and proof-of -principle cohort study[J].Lancet,2009,373(9671):1275-1281.
  • 3Schlaich MP,Sobotka PA,Krum H,et al.Renal sympathetic-nerve ablation for uncontrolled hypertension[J].N Engl J Med,2009,361(9):932-934.
  • 4Esler MD,Krum H,Sobotka PA,et al.Renal sympathetic denervation in patients with treatment-resistant hypertension(The Symplicity HTN-2 Trial):a randomised controlled trial[J].Lancet,2010,376(9756):1903-1909.
  • 5Symplicity HTN-1 investigators.Catheter-based renal sympathetic denervation for resistant hypertension:durability of blood pressure reduction out to 24 months[J].Hypertension,2011,57(5):911-917.
  • 6Gosain P,Garimella PS,Hart PD,et al.Renal sympathetic denervation for treatment of resistant hypertension:a systematic review[J].J Clin Hypertens,2013,15(1):75-84.
  • 7蒋雄京.经皮经导管射频消融去肾交感神经术治疗难治性高血压:挑战与机会并存,现实离期望多远?[J].中华高血压杂志,2013,21(5):401-402. 被引量：7
  • 8孙宁玲,霍勇,王继光,李南方,陶军,李勇,严晓伟,蒋雄京,李学旺.难治性高血压诊断治疗中国专家共识[J].中华高血压杂志,2013,21(4):321-326. 被引量：152
  • 9吴兆苏,朱鼎良,蒋雄京,孙宁玲,张宇清,高平进,李南方,谢良地,陈鲁原,陶军,祝之明,曾春雨,李卫,李新立.中国高血压联盟关于经皮经导管射频消融去肾交感神经术治疗难治性高血压的立场与建议[J].中华高血压杂志,2013,21(5):419-423. 被引量：16
  • 10Mahfoud F,Luscher TF,Andersson B,et al.Expert consensus document from the European Society of Cardiology on catheter-based renal denervation[J].Eur Heart J,2013,doi:10.1093/eurheartj/eht154[Epub ahead of print].

二级参考文献65

  • 1Calhoun DA, Jones D, Textor S, et al. Resistant hypertension:diagnosis, evaluation and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension, 2008, 51 : 1403-1419.
  • 2Krum H, Sobotka P, Mahfoud F, et al. Device-based antihypertensive therapy: therapeutic modulation of the autonomic nervous system. Circulation, 2011,123 : 209-221.
  • 3Krum H, Schlaich M, Whitbourn R, et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof -of -principle cohort study. Lancet, 2009,373 : 1275-1281.
  • 4Schlaich MP, Sobotka PA, Krum H, et al. Renal sympathetic-nerve ablation for uncontrolled hypertension. N Engl J Med, 2009, 361 : 932-934.
  • 5Symplicity HTN-1 investigators. Catheter-based renal sympathetic denervation for resistant hyptersion: durability of blood pressure reduction out to 24 months. Hypertension, 2011,57:911-917.
  • 6Esler MD, Krum H, Sobotka PA, et al. Renal sympathetic denervation in patients with treatment-resistant hypertension ( The Symplicity HTN-2 Trial) : a randomised controlled trial. Lancet, 2010,376 : 1903-1909.
  • 7Prochnau D, Lauten A, Busch M, et al. Catheter-based radiofrequency ablation therapy of the renal sympathetic-nerve system for drug resistant hypertension in a patient with end-stage renal disease. Int J Cardiol,2012,154 : e29-30.
  • 8Ukena C, Mahfoud F, Kindermann I, et al. Cardiorespiratory response to exercise after renal sympathetic denervation in patients with resistant hypertension. J Am Coll Cardiol, 2011,58: 1176- 1182.
  • 9Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med, 1999, 130: 461-470.
  • 10Schlaich MP, Lambert E, Kaye DM, et al. Sympathetic augmentation in hypertension: role of nerve firing, norepinephrine reuptake, and angiotensin neuromodulation. Hypertension, 2004, 43 : 169-175.

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临床内科杂志
2014年 第1期

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