Renal sympathetic efferent and afferent nerves, which lie within and immediately adjacent to the wall of the renal arteries, contribute to the maintenance of hypertension. Because the causative factors of hypertension change over time, denervation of both efferent and afferent renal nerves should result in long-term attenuation of hypertension. The importance of the renal nerves in hypertensive patients can now be defined with the novel development of percutaneous minimally invasive renal denervation from within the renal artery using radio-frequency energy as a therapeutic strategy. This manuscript reviews the results of renal denervation in patients with resistant essential hypertension reported thus far, emphasizes the safety of this minimally invasive technique, notes new insights about the function of the renal nerves in hypertension that have been learned from these initial studies, considers the many cardiovascular disorders for which this therapy may have clinical value, and suggests potential long-term cardiovascular, renal, and metabolic benefits to hypertensive patients who undergo renal denervation.%肾脏交感的传入和传出神经系统毗邻肾动脉血管壁或存在于肾动脉血管壁内部.肾脏传入、传出交感神经系统的激活,对高血压的维持起重要作用.由于高血压的诱发因素随时间流逝而变化,对肾脏传入及传出神经的去神经治疗可以降低高血压程度.现回顾迄今为止对于顽固的原发性高血压患者的去神经治疗的研究,强调最小能量的侵入性治疗方法的安全性.通过这些研究表明肾脏神经在高血压中的地位.强调这项治疗措施对于心血管系统功能紊乱的治疗可能产生的临床价值,阐明采用肾脏去神经治疗对于高血压患者的心血管、肾脏以及代谢系统获益.
展开▼
