经导管射频消融去肾交感神经支配术对难治性高血压患者晨峰的影响

摘要

目的：探讨和总结经导管射频消融去肾交感神经支配术(RSD)对难治性高血压患者血压晨峰的影响。方法60例难治性高血压患者随机分为对照组和治疗组,每组30例。对照组给予氢氯噻嗪片12.5 mg/d、替米沙坦片40 mg/d 、硝苯地平控释片30 mg/d口服,共8周；治疗组在给予上述药物基础上行经导管射频消融去肾交感神经支配术。观察治疗前后两组患者血压晨峰变化的情况。结果对照组和治疗组均能使难治性高血压晨峰降低,对照组血压晨峰下降的幅度为收缩压(34.13±1.21)mm Hg(1 mm Hg=0.133 kPa),舒张压(12.11±2.10)mm Hg,治疗组血压晨峰下降的幅度分别为收缩压(35.53±2.11)mm Hg,舒张压(13.31±2.30)mm Hg,两组比较差异具有统计学意义(P<0.05)。结论对于难治性高血压晨峰的控制,治疗组优于对照组,经导管射频消融去肾交感神经支配术能够有效控制难治性高血压患者的晨峰现象。%Objective To investigate and summarize the influence of radiofrequency catheter ablation renal sympathetic denervation (RSD) on morning blood pressure surge of refractory hypertension patients. Methods A total of 60 refractory hypertension patients were randomly divided into control group and treatment group, with 30 cases in each group. The control group received 12.5 mg/d of hydrochlorothiazide tablets, 40 mg/d of telmisartan tablets, and 30 mg/d of nifedipine controlled release tablets by oral administration for 8 weeks. The treatment group underwent additional radiofrequency catheter ablation RSD. The changes of morning blood pressure surge before and after treatment in the two groups were observed. Results The morning blood pressure surge decreased both in the two groups. The decrease ranges in the control group were systolic blood pressure as (34.13±1.21) mm Hg (1 mm Hg=0.133 kPa), diastolic blood pressure as (12.11±2.10) mm Hg, and those in the treatment group were systolic blood pressure as (35.53±2.11) mm Hg, diastolic blood pressure as (13.31±2.30) mm Hg. There was statistically significant difference between the two groups (P<0.05). Conclusion The treatment group has better effect in treating refractory hypertension than the control group. The application of radiofrequency catheter ablation RSD can effectively control the morning blood pressure surge of refractory hypertension patients.