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摘要: 近年来大量研究发现高血压与副肾动脉息息相关，副肾动脉是肾动脉最具意义的变异，与肾脏血管介入治疗、肾肿瘤切除、肾移植等技术密切相关。本文主要对副肾动脉可能引起高血压的机制及相关治疗方法等热点问题展开论述。Abstract: In recent years, a large number of studies have found that hypertension is closely related to the accessory renal artery. Accessory renal artery is the most significant variation of renal artery, which is closely related to renal vascular intervention, renal tumor resection, renal transplantation and other techniques. This article mainly discusses the mechanism and related treatment of hypertension caused by accessory renal artery.
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Key words:
- hypertension /
- accessory renal artery /
- renal denervation
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[1] 姚溪, 裴晓婷, 曲哲. 1991—2015年中国成人高血压患病率、知晓率、治疗率、控制率的变化趋势及其影响因素研究[J]. 中国全科医学, 2022, 25(7): 803-814. doi: 10.12114/j.issn.1007-9572.2022.00.004
[2] 刘力生, 龚兰生. 中国高血压防治指南(试行本)[J]. 中国医药导刊, 2000, 20(1): 3-25. https://www.cnki.com.cn/Article/CJFDTOTAL-DKYY200001000.htm
[3] 李莉. 中国高血压指南二十年[J]. 中国循证心血管医学杂志, 2020, 12(2): 129-130. doi: 10.3969/j.issn.1674-4055.2020.02.01
[4] 陈达. 高血压发病机制研究进展[J]. 医学理论与实践, 2020, 33(22): 3722-3724, 3727. doi: 10.19381/j.issn.1001-7585.2020.22.010
[5] Marshall AG. Aberrant renal arteries and hypertension[J]. Lancet, 1951, 2(6686): 701-705.
[6] Gupta A, Tello R. Accessory renal arteries are not related to hypertension risk: a review of MR angiography data[J]. AJR Am J Roentgenol, 2004, 182(6): 1521-1524. doi: 10.2214/ajr.182.6.1821521
[7] 徐小玲, 麻少辉, 李国良, 等. 利用CTA初步探讨副肾动脉与原发性高血压的关系及其机制[J]. 实用放射学杂志, 2017, 33(12): 1921-1924. doi: 10.3969/j.issn.1002-1671.2017.12.029
[8] Shen J, Lyu L, Wu X, et al. Correlation between renal artery anatomy and hypertension: a retrospective analysis of 3000 patients[J]. Evid Based Complement Alternat Med, 2021, 2021: 9957361.
[9] Kang K, Ma Y, Jia C, et al. Relationship between accessory renal artery and clinical characteristics of middle-aged patients with primary hypertension[J]. Int J Hypertens, 2020, 2020: 7109502.
[10] Ali Mohammed AM, Elseed Abdalrasol RG, Alamin Abdalhai K, et al. Accessory renal vessels[J]. Acta Inform Med, 2012, 20(3): 196-197. doi: 10.5455/aim.2012.20.196-197
[11] Ozkan U, Oğuzkurt L, Tercan F, et al. Renal artery origins and variations: angiographic evaluation of 855 consecutive patients[J]. Diagn Interv Radiol, 2006, 12(4): 183-186.
[12] 张际青, 张小东. 副肾动脉定义商榷[J]. 中国临床解剖学杂志, 2010, 28(1): 109-110. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLJZ201001039.htm
[13] Lauder L, Ewen S, Tzafriri AR, et al. Renal artery anatomy assessed by quantitative analysis of selective renal angiography in 1, 000 patients with hypertension[J]. EuroIntervention, 2018, 14(1): 121-128. doi: 10.4244/EIJ-D-18-00112
[14] Sato Y, Kawakami R, Jinnouchi H, et al. Comprehensive assessment of human accessory renal artery periarterial renal sympathetic nerve distribution[J]. JACC Cardiovasc Interv, 2021, 14(3): 304-315. doi: 10.1016/j.jcin.2020.09.043
[15] Atherton DS, Deep NL, Mendelsohn FO. Micro-anatomy of the renal sympathetic nervous system: a human postmortem histologic study[J]. Clin Anat, 2012, 25(5): 628-633. doi: 10.1002/ca.21280
[16] Sakakura K, Ladich E, Cheng Q, et al. Anatomic assessment of sympathetic peri-arterial renal nerves in man[J]. J Am Coll Cardiol, 2014, 64(7): 635-643. doi: 10.1016/j.jacc.2014.03.059
[17] Chan PL, Tan F. Renin dependent hypertension caused by accessory renal arteries[J]. Clin Hypertens, 2018, 24: 15. doi: 10.1186/s40885-018-0100-x
[18] 罗东, 张应和, 覃智颖, 等. 副肾动脉多排螺旋CT血管成像与肾血管性高血压相关性研究[J]. 检验医学, 2016, 31: 56-58.
[19] O'Neill WC, Bardelli M, Yevzlin AS. Imaging for renovascular disease[J]. Semin Nephrol, 2011, 31(3): 272-282. doi: 10.1016/j.semnephrol.2011.05.007
[20] 邢媛媛, 勇强. 彩色多普勒超声诊断高血压患者副肾动脉的价值[J]. 中国超声医学杂志, 2017, 33(9): 803-805. doi: 10.3969/j.issn.1002-0101.2017.09.013
[21] 牛建栋, 郭玉林, 尚志荣, 等. 副肾动脉直径与肾血管性高血压的相关性[J]. 中国医学影像技术, 2015, 31(2): 240-243. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXX201502031.htm
[22] Bude RO, Forauer AR, Caoili EM, et al. Is it necessary to study accessory arteries when screening the renal arteries for renovascular hypertension?[J]. Radiology, 2003, 226(2): 411-416. doi: 10.1148/radiol.2263011576
[23] Chung AA, Millner PR. Accessory renal artery stenosis and secondary hypertension[J]. Case Rep Nephrol, 2020, 2020: 8879165.
[24] Glodny B, Cromme S, Wortler K, et al. A possible explanation for the frequent concomitance of arterial hypertension and multiple renal arteries[J]. Med Hypotheses, 2001, 56(2): 129-133.
[25] 中华医学会内分泌学分会. 原发性醛固酮增多症诊断治疗的专家共识(2020版)[J]. 中华内分泌代谢杂志, 2020, 36(9): 727-736. doi: 10.3760/cma.j.cn311282-20200615-00444
[26] VonAchen P, Hamann J, Houghland T, et al. Accessory renal arteries: Prevalence in resistant hypertension and an important role in nonresponse to radiofrequency renal denervation[J]. Cardiovasc Revasc Med, 2016, 17(7): 470-473. doi: 10.1016/j.carrev.2016.07.009
[27] 邹金兵, 韩津津, 韩丽华. 难治性高血压的定义演变与最新研究进展[J]. 中国医学创新, 2021, 18(8): 175-179. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYCX202108047.htm
[28] Bhatt DL, Kandzari DE, O'Neill WW. A controlled trial of renal denervation for resistant hypertension[J]. J Vasc Surg, 2014, 60(1): 266.
[29] Symplicity HTN-2 Investigators, Esler MD, Krum H, et al. Renal sympathetic denervation in patients with treatment-resistant hypertension(The Symplicity HTN-2 Trial): a randomised controlled trial[J]. Lancet, 2010, 376(9756): 1903-1909.
[30] Symplicity HTN-1 Investigators. Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months[J]. Hypertension, 2011, 57(5): 911-917.
[31] Kandzari DE, Bhatt DL, Brar S, et al. Predictors of blood pressure response in the SYMPLICITY HTN-3 trial[J]. Eur Heart J, 2015, 36(4): 219-227.
[32] Fengler K, Ewen S, Höllriegel R, et al. Blood pressure response to main renal artery and combined main renal artery plus branch renal denervation in patients with resistant hypertension[J]. J Am Heart Assoc, 2017, 6(8): 110.
[33] de Jong MR, Hoogerwaard AF, Gal P, et al. Persistent increase in blood pressure after renal nerve stimulation in accessory renal arteries after sympathetic renal denervation[J]. Hypertension, 2016, 67(6): 1211-1217.
[34] Id D, Kaltenbach B, Bertog SC, et al. Does the presence of accessory renal arteries affect the efficacy of renal denervation?[J]. JACC Cardiovasc Interv, 2013, 6(10): 1085-1091.
[35] Kandzari DE, Böhm M, Mahfoud F, et al. 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[J]. Lancet, 2018, 391(10137): 2346-2355.
[36] Townsend RR, Mahfoud F, Kandzari DE, 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[J]. Lancet, 2017, 390(10108): 2160-2170.
[37] Azizi M, Schmieder RE, Mahfoud F, et al. Endovascular ultrasound renal denervation to treat hypertension(RADIANCE-HTN SOLO): a multicentre, international, single-blind, randomised, sham-controlled trial[J]. Lancet, 2018, 391(10137): 2335-2345.
[38] 王捷. 2021年欧洲高血压学会关于经导管去肾交感神经术立场文件的解读: 经导管去肾交感神经术真的要来了![J]. 中国介入心脏病学杂志, 2021, 29(10): 554-557. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXB202110003.htm
[39] Schirmer SH, Sayed MM, Reil JC, et al. Improvements in left ventricular hypertrophy and diastolic function following renal denervation: effects beyond blood pressure and heart rate reduction[J]. J Am Coll Cardiol, 2014, 63(18): 1916-1923.
[40] Hering D, Marusic P, Walton AS, et al. Renal artery anatomy affects the blood pressure response to renal denervation in patients with resistant hypertension[J]. Int J Cardiol, 2016, 202: 388-393.
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