李敏,范芳芳,张岩,周菁,马为,霍勇

• 1:北京大学第一医院心内科
• 2:北京大学第一医院心血管疾病研究所
• 3:北京大学第一医院超声心动图中心实验室

摘要(Abstract)：

目的研究肾交感神经消融术(RDN)在高血压治疗中的有效性,同时进一步评估其安全性。方法检索中英文数据库,包括The Cochrane Library、Pub Med、Embase、MEDLINE、中国知网、万方,时间截至2020年5月。搜索与RDN相关的随机对照研究,试验组为行RDN治疗高血压的患者,对照组为常规治疗或者假手术组,血压的评估方法包括24h动态血压或诊室血压,收集治疗前后的收缩压及舒张压,同时记录每个研究中出现的不良事件。结果最终纳入13项研究,共1841例患者。研究结果显示,与对照组相比,试验组不论收缩压还是舒张压均显著下降,试验组的24 h动态血压收缩压平均降低了3.97 mm Hg(95%CI–5.15～–2.79,P<0.00001;1mm Hg=0.133k Pa),诊室收缩压降低了8.82mm Hg(95%CI–13.03～–4.61,P <0.0001),24h动态血压舒张压平均降低了1.95mm Hg(95%CI–2.70～–1.20,P<0.00001),诊室舒张压降低了4.39 mm Hg(95%CI–6.05～–2.73,P<0.00001)。试验组的不良事件发生率(16.7%)与对照组(12.1%)相比,差异无统计学意义。对24 h动态血压收缩压进行亚组分析,结果显示对基线心率≥72次/分、服用降压药物数目<5种者RDN降压效果更明显,但交互作用不显著。结论 RDN可以显著降低高血压患者的血压水平且不会增加不良事件。

关键词(KeyWords)： 肾交感神经消融术;高血压;荟萃分析

Abstract:

Keywords:

基金项目(Foundation): 农村心脑血管病综合防控关键技术应用示范研究（2017YFC1307704）;; 北大医学交叉研究种子基金项目（BMU2018MX002）

作者(Author): 李敏,范芳芳,张岩,周菁,马为,霍勇

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