【黑科技】降血压只能依靠药物？这款降压器械正在颠覆你的想象力！

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                    <section><section><p><p><img src="image/20201014/86b79d371e9862b01189f0252a03b2cd_1.png" /></p></p></section><section><section><span><strong></strong></span></section><p><span>医疗器械第一新媒体</span></p><p><span>分享最专业的医疗器械知识</span></p></section><section><section><section>关注</section></section></section></section><section><section><section><section data-width="97%"><section><br  /></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><p><img src="image/20201014/e53586adc32203dccebc83ee1b1ac15b_2.jpg" /></p></section></section></section><section powered-by="gulangu"><section><section><p>2018年的世界杯的比赛颠覆了所有人的想象，无论是卫冕冠军提前出局，还是梅西、C罗“绝代双骄”的相继退场，亦或是用速度搏出C位的法国新一代黑马……其实颠覆认知的不止是比赛，还有各种黑科技，视频助理裁判VAR技术、嵌入NFC芯片的比赛用球、智能球靴等等，这些黑科技也在向人们证明：科技正在颠覆传统。</p><p>&nbsp;</p><p>和世界杯一样，医疗领域的科技创新往往也是颠覆性的。<span>在心血管领域就有这样一个热议的疗法——<em>肾神经消融（RDN）</em>，这是一种<em>治疗未被控制的高血压（Uncontrolled hypertension）的创新疗法</em></span>，它不仅改写了历史，为高血压治疗提供了另一种可能，它本身的发展史也有一段跌宕起伏的故事。</p></section></section></section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><section><section><p><img src="image/20201014/c7f582878b39eb6c77beb162cdf67582_3.jpg" /></p></section></section><section><p><strong>居高不下的高血压</strong></p></section><section><section><p><img src="image/20201014/36534a8d26a0749a98abc875adaf26f5_4.jpg" /></p></section></section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><img src="image/20201014/611e07eb4bc15c8a0e3de8531515e72d_5.jpg" /></p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>高血压对大家来说都不陌生，它是冠心病、脑卒中等多种心脑血管疾病的高危因素，根据《中国心血管病报告2016》概要，我国成人高血压患病率为25.2%，而得到控制的比例仅为13.8%，<span>大部分患者血压都没有得到良好的控制</span>。</p><p>&nbsp;</p><p>虽然有传统的药物治疗，但一些患者往往因为血压控制不好，而不得不服用多种药物，患者每天把药当饭吃，还是很难坚持的，因此很多患者都存在漏服药或不按医嘱服药，这又会导致血压波动，恶性循环。</p><p>&nbsp;</p><p>有没有一种疗法可以减少服药的剂量，改善血压的状况呢？</p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><section><section><p><img src="image/20201014/c7f582878b39eb6c77beb162cdf67582_3.jpg" /></p></section></section><section><p><strong>颠覆性的黑科技</strong></p></section><section><section><p><img src="image/20201014/36534a8d26a0749a98abc875adaf26f5_4.jpg" /></p></section></section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>研究人员发现，<span>交感神经活性的异常增高是高血压的重要致病机制之一</span>。这是什么意思呢？</p><p>&nbsp;</p><p><span></span></p><p>简单来说，交感神经是一群不安分的家伙，它们住在你的身体里就喜欢搞点事情，平时制造一点紧张、兴奋、恐怖的气氛是它们的拿手戏。但是如果它们太兴奋，不分昼夜、不分场合地开party，气氛搞得太嗨，停也停不下来，这就可能导致高血压。这时候最简单的方式就是——上警棍！直接电击倒地，干脆利落。</p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><img src="image/20201014/4bf21a63a2941819fd2dcd2b83c15b3a_8.jpg" /></p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>RDN的原理就是通过微创介入技术，在肾动脉内进行射频消融，“电死”大部分肾交感神经，从而达到降低血压的目的。</p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><img src="image/20201014/a8193c723b38f2586c60996b23d5068a_9.jpg" /></p></section></section></section><section powered-by="gulangu"><section><section><p>第一代单电级消融导管</p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>尽管早在上世纪 20 年代，有过采用外科切除肾脏交感神经来降低严重高血压的报道，但是由于严重的并发症等问题，在RDN问世前，大多数医生倾向于用药物控制血压，而不是依靠手术。</p><p>&nbsp;</p><p>RDN颠覆了所有人的认知，因此自从2009年澳大利亚学者Krum等首次报道，RDN疗法就被寄予厚望，随后的一系列研究结果也相继证明<span>RDN不仅可以有效降压，而且没有显著并发症</span>。RDN疗法因此得到了认可，国外也多次报道了RDN疗法的成功案例。</p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><section><section><p><img src="image/20201014/c7f582878b39eb6c77beb162cdf67582_3.jpg" /></p></section></section><section><p><strong>创新之路一波三折</strong></p></section><section><section><p><img src="image/20201014/36534a8d26a0749a98abc875adaf26f5_4.jpg" /></p></section></section></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p><p>就在RDN看似一路开挂，即将走上历史舞台时，2014年却突然遭遇了滑铁卢，Symplicity HTN-3研究未能达到预期的显著效果，一时间学术界一片哗然。</p><p>&nbsp;</p><p>面对外界的质疑，研究人员并没有放弃，他们发现并不是因为研究方向上出了错，而是研究设计中存在着一些漏洞和干扰因素，因此开始积极反思并作出改进。</p><p>&nbsp;</p></section></section></section><section powered-by="gulangu"><section><section><p><img src="image/20201014/2bf25573edc7ee490aabf12be8a6b04c_12.jpg" /></p></section></section></section><section powered-by="gulangu"><section><section><p>新一代多电极消融导管</p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>为了排除多种干扰因素，研究人员重新设计了两项不同条件下的研究：一个是受试者完全不服药（SPYRAL HTN-OFF MED），另一个让受试者服药，但严格控制服药剂量（SPYRAL HTN-ON MED）。相比之前的研究，这两项研究的患者服药更加精准，研究人群更加广泛，并且将射频导管从单电极升级为多电极，这些改进都使得研究更加严谨科学。<br  /></p><p>&nbsp;</p><p>2017年8月和2018年5月，美敦力分别公布了这两项研究的数据。<span>最新的试验结果显示应用新一代射频消融导管Symplicity Spyral治疗的高血压患者，进行24小时动态血压监测，无论是平均收缩压还是平均舒张压，都有明显降低，比假手术对照组降血压效果更为明显，并且在六个月内没有显著的安全性不良事件<span>1,2</span>。</span></p><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><img src="image/20201014/4feb49a7b8f8d44d241e59e1c62551a3_13.jpg" /></p></section></section></section><section powered-by="gulangu"><section><section><p><span>新一代</span><span>RDN</span><span>与第一代</span><span>RDN</span><span>的对</span><span>比</span><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section><p>最新研究结果的公布无疑给RDN疗法带来了新生，专家们认为将极大推动RDN疗法的发展，为更多高血压患者带来新希望。</p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section></section></section></section><section powered-by="gulangu"><section><section><p>尽管在科学研究的征途上，有时会遇到风浪，但只要怀揣着一颗探求真知的初心，从失败中总结经验，不断改进创新，就会有绝处逢生，柳暗花明的那一天，我们也期待RDN疗法未来能够造福更多高血压患者。</p></section></section></section><section powered-by="gulangu"><section><section><p><br  /></p></section></section></section><section powered-by="gulangu"><section><section></section><section><section powered-by="gulangu"><section><section><p><span><strong>参考文献</strong></span></p><p><br  /></p><p>[1] Kandzari DE,et al.Effect of renal denervation on blood<br  /></p><p>pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial. Lancet.2018 Jun 9;391(10137):2346-2355.</p><p><span><br  /></span></p><p><span>[2] Townsend RR,et al.Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF MED): a randomised,sham-controlled, proof-of-concept trial. Lancet. 2017 Nov 11;390(10108):2160-2170.&nbsp;</span></p><p><span><br  /></span></p></section></section></section></section></section></section><section powered-by="gulangu"><section><section></section></section></section><p><br  /></p><p><strong><span></span></strong></p><section data-id="1658"><section><section><section data-id="1658"><section><section><section data-id="1658"><section><section><section data-id="1658"><section><section><p><span><strong>相关阅读</strong></span></p></section><p><p><img src="image/20201014/ec237188ae1e9c03eb4d9814f31b18ab_14.gif" /></p></p><p><span>【器械评测】具有自主知识产权的智能脉搏波血压仪</span></p><p><br  /></p><p><span>『大开眼界』血压计的由来</span></p><p><br  /></p><p><span>电子血压计到底准不准？听听医生怎么说</span></p><p><br  /></p><p><span>别认为可穿戴设备只能记步数，来看看高端的怎么玩！</span></p><p><br  /></p><p><span>『大开眼界』“贴在额头上”的血氧仪</span></p><p><span></span><br  /></p><p><span>【黑科技】血压计闹“革命”——新型血压传感器问世</span></p></section></section></section></section></section></section></section></section></section></section></section><section data-id="1658"><section><section><section data-id="1658"><section><section><section data-id="1658"><section><section><section data-id="1658"><section><section><p><br  /></p></section></section></section></section></section></section></section></section></section></section></section></section><p><p><img src="image/20201014/9742a7de2ee28aa329d08045618d2f59_15.jpg" /></p></p>