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本文引用的文献

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Dual endothelin antagonist aprocitentan for resistant hypertension (PRECISION): a multicentre, blinded, randomised, parallel-group, phase 3 trial.阿普西坦坦治疗耐药性高血压的双内皮素拮抗剂研究(PRECISION):一项多中心、盲法、随机、平行分组、3 期临床试验。
Lancet. 2022 Dec 3;400(10367):1927-1937. doi: 10.1016/S0140-6736(22)02034-7. Epub 2022 Nov 7.
2
Perirenal adipose afferent nerves sustain pathological high blood pressure in rats.肾周脂肪传入神经维持大鼠病理性高血压。
Nat Commun. 2022 Jun 6;13(1):3130. doi: 10.1038/s41467-022-30868-6.
3
Effect of fecal microbiota transplantation on primary hypertension and the underlying mechanism of gut microbiome restoration: protocol of a randomized, blinded, placebo-controlled study.粪便微生物群移植对原发性高血压的影响及肠道微生物组恢复的潜在机制:一项随机、双盲、安慰剂对照研究方案。
Trials. 2022 Feb 24;23(1):178. doi: 10.1186/s13063-022-06086-2.
4
High-Intensity Focused Ultrasound: A Review of Mechanisms and Clinical Applications.高强度聚焦超声:机制与临床应用综述。
Ann Biomed Eng. 2021 Sep;49(9):1975-1991. doi: 10.1007/s10439-021-02833-9. Epub 2021 Aug 10.
5
Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomised, sham-controlled trial.在不使用抗高血压药物的情况下基于导管的肾脏去神经术的疗效(SPYRAL HTN-OFF MED Pivotal):一项多中心、随机、假对照试验。
Lancet. 2020 May 2;395(10234):1444-1451. doi: 10.1016/S0140-6736(20)30554-7. Epub 2020 Mar 29.
6
Perirenal Fat: A Unique Fat Pad and Potential Target for Cardiovascular Disease.肾周脂肪:一种独特的脂肪垫及心血管疾病的潜在靶点。
Angiology. 2019 Aug;70(7):584-593. doi: 10.1177/0003319718799967. Epub 2018 Oct 9.
7
Morbid obesity and hypertension: The role of perirenal fat.病态肥胖与高血压:肾周脂肪的作用。
J Clin Hypertens (Greenwich). 2018 Oct;20(10):1430-1437. doi: 10.1111/jch.13370. Epub 2018 Sep 14.
8
Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial.肾神经去交感神经术对降压药物治疗患者血压的影响:SPYRAL HTN-ON MED 概念验证随机试验的 6 个月疗效和安全性结果。
Lancet. 2018 Jun 9;391(10137):2346-2355. doi: 10.1016/S0140-6736(18)30951-6. Epub 2018 May 23.
9
Hypertension Prevalence and Control Among Adults: United States, 2015-2016.美国成年人高血压患病率及控制情况:2015 - 2016年
NCHS Data Brief. 2017 Oct(289):1-8.
10
Prevalence, awareness, treatment, and control of hypertension in China: data from 1·7 million adults in a population-based screening study (China PEACE Million Persons Project).中国高血压的患病率、知晓率、治疗率和控制率:一项基于人群筛查研究的 170 万成年人数据(中国高血压调查)。
Lancet. 2017 Dec 9;390(10112):2549-2558. doi: 10.1016/S0140-6736(17)32478-9. Epub 2017 Nov 5.

聚焦超声介导肾周脂肪修饰治疗原发性高血压的疗效:一项多中心、随机、双盲、假对照研究方案。

Effect of focused power ultrasound-mediated perirenal fat modification on primary hypertension: protocol of a multicenter, randomized, double-blinded, sham-controlled study.

机构信息

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210000, China.

Gusu School, Nanjing Medical University, Suzhou, 215100, China.

出版信息

Trials. 2023 Mar 23;24(1):221. doi: 10.1186/s13063-023-07249-5.

DOI:10.1186/s13063-023-07249-5
PMID:36959658
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10035202/
Abstract

BACKGROUND

Perirenal fat plays a key role in sustaining pathological high blood pressure. We aim to investigate the efficacy of intervention for perirenal fat mediated by focused power ultrasound (FPU) on primary hypertension.

METHODS

A multicenter, randomized, sham-controlled, double-blinded trial will be implemented in 200 participants with mild to moderate hypertension. All enrolled participants will be randomly allocated to perirenal fat modification (PFM) intervention using FPU or sham-procedure at a ratio of 1:1 and will be followed up at 24 h, 14 days, 30 days, and 90 days after the intervention. The primary endpoint is changes in office systolic blood pressure (SBP) at 30 days compared with baseline. The secondary endpoints include the changes in office SBP from baseline to 90 days, changes in 24-h mean SBP from baseline to 30 days and 90 days, and changes in heart rate from baseline to 30 days. Safety endpoint is defined as any severe adverse events related to the intervention.

DISCUSSION

The present study is the first to use noninvasive FPU to intervene in perirenal fat to achieve the goal of reducing blood pressure for patients with essential hypertension. Our study is expected to provide a new treatment strategy to control high blood pressure.

TRIAL REGISTRATION

ClinicalTrials.gov. NCT05049096. Registered on September 7, 2021.

PROTOCOL VERSION

Version 1.3.1, data 23 August 2021.

SPONSOR

Prof. Xiangqing Kong is the principal investigator of this trial.

摘要

背景

肾周脂肪在维持病理性高血压中起着关键作用。我们旨在研究聚焦超声(FPU)介导的肾周脂肪干预对原发性高血压的疗效。

方法

将在 200 名轻中度高血压患者中进行一项多中心、随机、假对照、双盲试验。所有入组患者将按 1:1 的比例随机分为 FPU 肾周脂肪修饰(PFM)干预组和假手术组,并在干预后 24 h、14 天、30 天和 90 天进行随访。主要终点是与基线相比,30 天时诊室收缩压(SBP)的变化。次要终点包括从基线到 90 天诊室 SBP 的变化、从基线到 30 天和 90 天 24 小时平均 SBP 的变化,以及从基线到 30 天心率的变化。安全性终点定义为与干预相关的任何严重不良事件。

讨论

本研究首次使用非侵入性 FPU 干预肾周脂肪,以实现降低原发性高血压患者血压的目标。我们的研究有望为控制高血压提供一种新的治疗策略。

试验注册

ClinicalTrials.gov. NCT05049096. 2021 年 9 月 7 日注册。

方案版本

第 1.3.1 版,数据日期 2021 年 8 月 23 日。

赞助商

孔祥清教授是该试验的主要研究者。