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find Keyword "难治性高血压" 2 results
  • Symplicity HTN-3是经皮肾动脉去神经术的序幕还是终点

    难治性高血压的发生会显著增加患者发生心血管事件的风险。交感神经在高血压的发病机制中至关重要,目前药物以外的治疗方法越来越得到重视,其中肾动脉去神经术(RDN)逐渐显示出治疗难治性高血压的潜力,RDN 分为射频消融、超声系统、化学技术3 个方法。目前RDN 研究的热点主要集中于经皮导管肾脏交感神经射频消融术。前期的非随机Symplicity HTN-1 实验以及随机非盲法Symplicity HTN-2 实验显示出了明显的降压效果。尽管后期严格设计、随机、假手术对照的Symplicity HTN-3 研究未能达到主要疗效终点,但这种药物以外的治疗方法值得进一步探讨,现以RDN 为核心话题作一综述。

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  • Effect of continuous positive airway pressure on blood pressure and related inflammatory factors in patients with obstructive sleep apnea hypopnea syndrome complicated with refractory hypertension

    ObjectiveTo investigate the effects of continuous positive airway pressure (CPAP) ventilation on blood pressure and related inflammatory factors in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and refractory hypertension, and explore the correlation between respiratory function and related inflammatory factors.MethodsPatients with OSAHS and refractory hypertension who visited Shenzhen Nanshan People’s Hospital between January 2014 and September 2018 were randomly divided into a CPAP group and a control group. The control group received routine treatment. The CPAP group received CPAP on the basis of conventional treatment. Each intervention lasted for 7 days. The changes of systolic and diastolic blood pressure were measured before and after 1, 3, 5, and 7 days, respectively. The respiratory function and related inflammatory factors were measured after 7 days of intervention.ResultsAfter 7 days of treatment in the CPAP group, the levels of apnea hyperpnoea index (AHI), lowest oxygen saturation and oxygen desaturation index were significantly better than those before intervention, with the improvement of respiratory function significantly higher than that of the control group after 7 days. Meanwhile the systolic and diastolic blood pressure levels were significantly lower in the CPAP group than those of the control group at 1, 3, 5, and 7 days, and lower than the pre-intervention after 7 days of intervention. After 7 days of intervention, the inflammatory factors in both groups were significantly improved (all P<0.05). However, the serum levels of high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and endothelin-1 (ET-1) in the CPAP group were significantly lower than those of the control group after 7 days of treatment (P<0.05). There was a significant positive correlation between AHI level and hs-CRP, IL-6, TNF-α and ET-1 in the CPAP group after intervention (P<0.001).ConclusionsCPAP can significantly improve the blood pressure of patients with OSAHS and refractory hypertension. CPAP may improve the related inflammatory factors by improving the respiratory function of patients, thus reduce the patient’s blood pressure.

    Release date:2019-07-19 02:21 Export PDF Favorites Scan
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