孟凡华,叶远征,马翔,马依彤

• 1:新疆医科大学第一附属医院心脏中心

摘要(Abstract)：

目的系统评价肾动脉交感神经消融术治疗顽固性高血压的有效性和安全性。方法计算机检索Pub Med、EMBASE、MEDLINE、Cochrane图书馆、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI),纳入肾动脉交感神经消融术与药物治疗顽固性高血压有效性及安全性的随机对照研究和队列研究。由两名评价员按照纳入与排除标准筛选文献,提取资料和评价质量后,采用Cochrane协作网提供的Rev Man 5.3统计软件进行Meta分析。结果共纳入7篇文献,包括3篇随机对照研究(共668例患者),4篇队列研究(共259例患者)。随机对照研究Meta分析结果显示:术后6个月肾动脉交感神经消融术组(RDN组)与对照组收缩压下降差异无统计学意义(WMD-18.85 mm Hg,95%CI-37.89~0.19,P=0.05)(1 mm Hg=0.133 k Pa),但RDN组舒张压下降显著高于对照组(WMD-7.08 mm Hg,95%CI-13.25~-0.90,P=0.02)。队列研究Meta分析结果显示:术后6个月RDN组收缩压和舒张压下降显著高于对照组(WMD-25.14 mm Hg,95%CI-30.50~-19.77,P<0.00001;WMD-6.13 mm Hg,95%CI-6.85~-5.42,P<0.00001)。手术并发症包括2例死亡、2例股动脉假性动脉瘤、1例肾动脉夹层。结论肾动脉交感神经消融术可显著降低顽固性高血压患者舒张压,但对降低收缩压疗效不明确。肾动脉交感神经消融术不良事件发生率较低,具有良好的安全性。高质量大规模多中心研究及术后长期随访是未来研究的重点。

关键词(KeyWords)： 肾动脉交感神经消融术;顽固性高血压;Meta分析

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 孟凡华,叶远征,马翔,马依彤

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