肾交感神经射频导管消融术在心力衰竭治疗中的应用

Application of Renal Sympathetic Denervation in Treatment of Heart Failure

心力衰竭是各种器质性心脏病的最终结局,是威胁人类健康的主要疾病之一。心力衰竭是一个重大的公共卫生问题,在中国成年人中的发病率超过0.9%,全球有超过一亿的人口罹患心力衰竭。虽然心力衰竭的治疗取得了重大进展,但心力衰竭患者的死亡率仍然很高,5年生存率为50%左右,迫切需要开发新的心力衰竭治疗方法。心力衰竭的特点是交感神经活性增加,慢性交感神经激活参与病理状态的维持。随着射频导管消融技术的发展,肾脏交感神经射频导管消融术已经成为一种侵入性,而且安全的方法,可以降低交感神经活性,而肾交感神经激活是心力衰竭和高血压的共同病理生理通道,先前的研究表明,肾脏交感神经消融术主要是通过肾动脉导管进行的神经消融,易于实施,也被证实是一种安全有效的微创手术。近年有关肾脏交感神经消融术用于治疗心力衰竭的研究不断涌现,现就相关研究予以综述。

Heart failure is the final outcome of various organic heart diseases and one of the major diseases threatening human health.Heart failure is a major public health problem.The incident rate among Chinese adults exceeds 0.9%,and more than one hundred million of the world s population are suffering from heart failure.In recent years,although significant progress has been made in the treatment of heart failure,the mortality rate is still high,and the five-year survival rate is about 50%.There is an urgent need to develop the new treatments for heart failure.Heart failure is characterized by increased sympathetic activity,and chronic sympathetic activation is involved in the maintenance of pathological state.With the development of catheter ablation technique,renal denervation has become an invasive and safe method to reduce sympathetic nerve activity.Renal sympathetic nerve activation is a common pathophysiological channel between heart failure and hypertension.Previous studies have shown that renal denervation is mainly performed through renal artery catheter ablation,which is easy to implement and proved to be a safe and effective minimally invasive operation.In recent years,researches on renal sympathetic nerve ablation for the treatment of heart failure have been emerging.This article mainly gives a summary based on the relevant research.