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超声肾去神经术降低血压的疗效:一项系统评价和荟萃分析。

Efficacy of ultrasound renal denervation reducing blood pressure: a systematic review and meta-analysis.

作者信息

Guerrero-Hernández Juan Miguel, Palomino-Ojeda Cristian Jesús, García-Mena Lissette Haydee, Maldonado-García José Luis, Vedia-Cruz Óscar Ángel, García-Donaire José Antonio, Núñez-Gil Iván Javier

机构信息

Servicio de Cardiología, Hospital Universitario Clínico San Carlos, Madrid, España Servicio de Cardiología Hospital Universitario Clínico San Carlos Madrid España.

Facultad de Ciencias de la Salud "Dr. Enrique Ortega Moreira-, Universidad Espíritu Santo, Samborondón, Ecuador Facultad de Ciencias de la Salud "Dr. Enrique Ortega Moreira- Universidad Espíritu Santo Samborondón Ecuador.

出版信息

REC Interv Cardiol. 2025 Apr 29;7(3):154-163. doi: 10.24875/RECICE.M25000509. eCollection 2025.

Abstract

INTRODUCTION AND OBJECTIVES

Ultrasound renal denervation (uRDN) has emerged as an innovative therapeutic approach for the treatment of hypertension. However, its efficacy compared to medication remains uncertain. We aimed to assess the efficacy profile of uRDN vs sham groups focusing on its impact on daytime ambulatory blood pressure, 24-hour blood pressure, home blood pressure and office blood pressure.

METHODS

We conducted a systematic search across Embase, PubMed, and Cochrane Library databases from their inception up 1 November 2024 to identify randomized controlled trials evaluating the efficacy of uRDN. Statistical analyses were performed using RevMan 6.3 software, utilizing the mean and standard deviation method to calculate mean differences with a 95% confidence interval (95%CI).

RESULTS

A total of 4 studies were included in the final analysis with 642 patients. uRDN significantly reduced daytime ambulatory systolic blood pressure (SBP) (-5.12 mmHg; 95%CI, -6.07 to -4.16; P ≤ .00001), 24-h SBP (-4.87 mmHg; 95%CI, -6.53 to -3.21]; P ≤ .00001), office SBP (-5.03 mmHg; 95%CI, -6.27 to -3.79; P ≤ .00001) and showed a decrease in patient medication 6 months after the procedure.

CONCLUSIONS

Using uRDN leads to a lower blood pressure in patients within 2 months following the procedure. Additionally, after 6 months a significant decrease in drug use is observed.This meta-analysis protocol was registered on PROSPERO on 7 July 2024 (CRD42024562852).

摘要

引言与目的

超声肾去神经术(uRDN)已成为治疗高血压的一种创新治疗方法。然而,与药物治疗相比,其疗效仍不确定。我们旨在评估uRDN组与假手术组的疗效,重点关注其对日间动态血压、24小时血压、家庭血压和诊室血压的影响。

方法

我们对Embase、PubMed和Cochrane图书馆数据库从创建到2024年11月1日进行了系统检索,以识别评估uRDN疗效的随机对照试验。使用RevMan 6.3软件进行统计分析,采用均值和标准差方法计算平均差值及95%置信区间(95%CI)。

结果

最终分析纳入了4项研究,共642例患者。uRDN显著降低了日间动态收缩压(SBP)(-5.12 mmHg;95%CI,-6.07至-4.16;P≤.00001)、24小时SBP(-4.87 mmHg;95%CI,-6.53至-3.21;P≤.00001)、诊室SBP(-5.03 mmHg;95%CI,-6.27至-3.79;P≤.00001),并且术后6个月患者用药量减少。

结论

使用uRDN可使患者在术后2个月内血压降低。此外,6个月后观察到药物使用量显著减少。本荟萃分析方案于2024年7月7日在PROSPERO上注册(CRD42024562852)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/12418244/044440f81e40/2604-7306-recic-7-3-154en-gf1.jpg

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