经皮肾动脉去交感神经术治疗合并高血压的慢性收缩性心力衰竭

发布时间：2018-04-26 05:17

本文选题：心力衰竭 + 慢性收缩性心力衰竭　；参考：《山东医药》2017年07期

【摘要】：目的观察经皮肾动脉去交感神经术(RDN)治疗合并高血压的慢性收缩性心力衰竭的临床效果。方法30例慢性收缩性心力衰竭患者,根据治疗前血压分为血压≥140/90 mm Hg者11例(1组)、血压140/90 mmHg者19例(2组),两组均行RDN治疗,术后两组各随访6个月。分别于治疗前、治疗6个月时检测两组血压,采集两组空腹静脉血检测血清N末端脑钠肽原(NT-proBNP)、肾小球滤过率(GFR),采用飞利浦i E33多普勒超声心动图仪观察两组射血分数(EF)、左室收缩末期内径(LVDS)、左室舒张末期内径(LVDD)、室间隔厚度(VST)。分别于治疗前、后对两组行6分钟步行实验。结果治疗前、治疗6个月时1组收缩压分别为(167.2±12.7)、(132.7±7.9)mm Hg,舒张压分别为(89.5±10.1)、(72.7±6.1)mm Hg,治疗前后比较,P均0.05。与治疗前比较,治疗后两组EF升高,LVDS、LVDD、VST降低,P均0.05,且2组各指标改善更明显,P均0.05。与治疗前比较,治疗后两组血清NT proBNP降低,P均0.05;与2组比较,治疗6个月时1组NT pro BNP降低更明显(P0.05)。与治疗前比较,治疗后两组6分钟步行实验距离增加,P均0.05;与2组比较,治疗6个月时1组6分钟步行实验距离改善更明显(P0.05)。结论 RDN治疗合并高血压的慢性收缩性心力衰竭效果较好,可降低患者血压,改善患者心功能,提高患者运动耐量。
[Abstract]:Objective To observe the clinical effect of percutaneous renal artery sympathetic nerve operation (RDN) in the treatment of chronic systolic heart failure with hypertension. Methods 30 patients with chronic systolic heart failure were divided into 11 cases (1 groups) with blood pressure above 140/90 mm Hg before treatment, 19 cases of 140/90 mmHg of blood pressure (2 groups), and the two groups were treated with RDN, and two groups followed each other after the operation. 6 months before treatment, two groups of blood pressure were detected at 6 months before treatment. Two groups of fasting venous blood were collected to detect N terminal brain natriuretic peptide (NT-proBNP), glomerular filtration rate (GFR), and two groups of ejection fraction (EF), left ventricular end systolic diameter (LVDS) and left ventricular end diastolic diameter (LVDD) were observed by PHILPS I E33 Doppler echocardiography. The thickness of interventricular septum (VST). Before treatment, 6 minutes walk test was performed in the two groups. The results showed that before treatment, the systolic pressure in the 1 groups was (167.2 + 12.7) and (132.7 + 7.9) mm Hg respectively, and the diastolic pressure was (89.5 + 10.1) and (72.7 + 6.1) mm Hg respectively. Before and after treatment, P 0.05. was compared with before treatment, and EF increased in two groups after treatment, LVDS, LVDD, VST decreased. P was 0.05, and the improvement of each index in the 2 groups was more obvious. P 0.05. was compared with before treatment. The serum NT proBNP decreased and P was 0.05 in the two groups after treatment. Compared with the 2 group, the 1 groups of NT Pro BNP decreased more obviously at 6 months. Compared with the treatment before treatment, the walking test distance was increased in two groups after treatment and P was 0.05; compared with group 2, 1 groups 6 minutes in 6 months and 6 1 groups 6 minutes when treated 6 months. The distance improvement of walking experiment is more obvious (P0.05). Conclusion the effect of RDN on chronic systolic heart failure with hypertension is better. It can reduce the blood pressure of the patients, improve the heart function of the patients and improve the patient's exercise tolerance.

【作者单位】：上海市普陀区中心医院;
【基金】：国家自然科学基金青年资助项目(81303145) 上海市卫计委重点项目(20134003);上海市卫计委面上项目(20140492);上海市卫计委医学重点专科建设项目(ZK2015A17)
【分类号】：R541.6;R544.1

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