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首页> 外文期刊>Hypertension: An Official Journal of the American Heart Association >Effects of renal sympathetic denervation on blood pressure, sleep apnea course, and glycemic control in patients with resistant hypertension and sleep apnea.
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Effects of renal sympathetic denervation on blood pressure, sleep apnea course, and glycemic control in patients with resistant hypertension and sleep apnea.

机译：抵抗性高血压和睡眠呼吸暂停患者肾交感神经去神经对血压，睡眠呼吸暂停进程和血糖控制的影响。

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摘要

Percutaneous renal sympathetic denervation by radiofrequency energy has been reported to reduce blood pressure (BP) by the reduction of renal sympathetic efferent and afferent signaling. We evaluated the effects of this procedure on BP and sleep apnea severity in patients with resistant hypertension and sleep apnea. We studied 10 patients with refractory hypertension and sleep apnea (7 men and 3 women; median age: 49.5 years) who underwent renal denervation and completed 3-month and 6-month follow-up evaluations, including polysomnography and selected blood chemistries, and BP measurements. Antihypertensive regimens were not changed during the 6 months of follow-up. Three and 6 months after the denervation, decreases in office systolic and diastolic BPs were observed (median: -34/-13 mm Hg for systolic and diastolic BPs at 6 months; both P<0.01). Significant decreases were also observed in plasma glucose concentration 2 hours after glucose administration (median: 7.0 versus 6.4 mmol/L; P=0.05) and in hemoglobin A1C level (median: 6.1% versus 5.6%; P<0.05) at 6 months, as well as a decrease in apnea-hypopnea index at 6 months after renal denervation (median: 16.3 versus 4.5 events per hour; P=0.059). In conclusion, catheter-based renal sympathetic denervation lowered BP in patients with refractory hypertension and obstructive sleep apnea, which was accompanied by improvement of sleep apnea severity. Interestingly, there are also accompanying improvements in glucose tolerance. Renal sympathetic denervation may conceivably be a potentially useful option for patients with comorbid refractory hypertension, glucose intolerance, and obstructive sleep apnea, although further studies are needed to confirm these proof-of-concept data.
机译：据报道，通过射频能量经皮肾交感神经去神经可通过减少肾交感神经传出和传入信号来降低血压（BP）。我们评估了该方法对耐药性高血压和睡眠呼吸暂停患者的血压和睡眠呼吸暂停严重程度的影响。我们研究了10例难治性高血压和睡眠呼吸暂停的患者（男7例，女3例;中位年龄：49.5岁），他们接受了肾脏去神经支配并完成了3个月和6个月的随访评估，包括多导睡眠监测和选定的血液化学检查以及BP测量。在随访的6个月中，降压方案没有改变。去神经后3个月和6个月，观察到办公室的收缩压和舒张压降低（中位数：6个月时收缩压和舒张压的中位数为-34 / -13 mm Hg; P均<0.01）。服用葡萄糖后2小时的血浆葡萄糖浓度也显着下降（中位数：7.0对6.4 mmol / L; P = 0.05）和6个月时血红蛋白A1C水平（中位数：6.1％对5.6％; P <0.05），以及肾去神经支配后6个月呼吸暂停低通气指数的下降（中位数：每小时16.3对4.5事件; P = 0.059）。总之，基于导管的肾交感神经去神经降低了难治性高血压和阻塞性睡眠呼吸暂停患者的血压，并伴有睡眠呼吸暂停严重程度的改善。有趣的是，葡萄糖耐量也随之提高。对于合并难治性高血压，葡萄糖耐受不良和阻塞性睡眠呼吸暂停的患者，肾脏交感神经支配可能是一种潜在的有用选择，尽管需要进一步的研究来确认这些概念验证数据。

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