高强度聚焦超声治疗难治性高血压的安全性和可行性研究
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Safety and feasibility of high intensity focused ultrasound in the treatment of resistant hypertension
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    摘要:

    目的:评价高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗难治性高血压(resistant hypertension,RH)的安全性和可行性。方法:对40例RH患者行HIFU去肾交感神经术治疗,治疗后随访患者6个月,评估术中及术后不良反应及并发症情况,术后血压下降效果、降压药物种类、肾动脉收缩期流速峰值和肾功能情况。结果:①40例患者均完成手术,治疗中主要不适为治疗区疼痛,一般在术后24 h内缓解。术后不良反应均在SIR-A~B级,无一例SIR-C~F级不良反应发生。②术后患者左、右肾动脉收缩期流速峰值较术前无差异(P=0.635,P=0.688)。术后患者随访1、6个月血尿素氮、血肌酐、肾小球滤过率较基线无统计学差异(P=0.772,P=0.652,P=0.366)。③术后随访1、3、6个月较基线诊室收缩压下降21.5、23.3、22.4 mmHg(P=0.000),诊室舒张压下降11.1、12.9、12 mmHg(P=0.000);24 h动态收缩压下降13.6、15.2、14.3 mmHg(P=0.000),24 h动态收缩压下降5.5、6、4.4 mmHg(P=0.000);药物种类下降0.8、0.9、1.0种(P=0.000)。结论:HIFU近期治疗RH是安全和可行的,但仍需深入及长期安全性、有效性探索。

    Abstract:

    Objective:To evaluate the safety and feasibility of high intensity focused ultrasound(HIFU) in the treatment of resistant hypertension. Methods:Totally 40 patients with resistant hypertension underwent the treatment of high intensity focused ultrasound were enrolled. Intraoperative and postoperative adverse effects were recorded;the drop of blood pressure,types of drug used,peak systolic velocity of renal artery and renal function were followed up to 6 months post treatment. Results:①All patients completed HIFU treatment successfully. The major discomforts that patients complained during the procedure was pain in the treatment area,which usually disappeared within 24 hours. Base on the SIR classification,most of adverse effects were classified as A to B;no C to F was found. ②Preoperative and postoperative peak systolic velocity of left and right renal artery had no statistic difference(P=0.635,P=0.688). The comparison between baseline and 1,6 months of blood urea nitrogen,serum creatinine and glomerular filtration rate had no statistic difference(P=0.772,P=0.652,P=0.366). ③The systolic blood pressure dropped 21.5,23.3,22.4 mmHg(P=0.000),diastolic blood pressure dropped 11.1,12.9,12 mmHg(P=0.000). 24-hour systolic blood pressure dropped 13.6,15.2,14.3 mmHg(P=0.000),24-hour diastolic blood pressure dropped 5.5,6,4.4 mmHg(P=0.000);and types of drug dropped 0.8,0.9,1.0(P=0.000) in the later 1,3,6 months. Conclusion:HIFU is safe and feasible in the treatment of resistant hypertension. However,further study about long-term safety and efficacy of HIFU is still needed.

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蒲铀,周崑,金成兵,陈星,容顺康,黄晶,朱辉.高强度聚焦超声治疗难治性高血压的安全性和可行性研究[J].重庆医科大学学报,2018,(3):382-

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  • 在线发布日期: 2019-05-30
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