<International Circulation> : Carotid Baroreflex Activation Therapy (BAT) as another technique， what about its mechanism and therapeutic effect?

　　《国际循环》：颈动脉压力激活疗法（BAT）作为另一种治疗，其作用机制及疗效如何？

　　Dr. Fink: Baroreceptor activation therapy has now been studied in a large number of human patients with hypertension. It is a much more invasive procedure than renal denervation. Renal denervation can be done through a catheter in a fairly short period of time. Baroreceptor activation therapy requires implantation of electrodes around the carotid sinuses in the patient and then they wear a stimulator like a pacemaker， so it is a substantially more interventional sort of therapy. So far trials have run， to my knowledge， at least a year or two and it appears as if this approach to a lowering of sympathetic nervous system activity， that is the purpose of baroreceptor activation therapy is to lower sympathetic activity， it appears to produce a prolonged and sustained and significant lowering of blood pressure. It is not clear all the mechanisms that contribute to this， certainly sympathetic inhibition is a major mechanism， but however we do not know at this point whether all sympathetic nerves are equally affected. There are some people who believe that mainly you need to inhibit the renal sympathetic nerves and that would be adequate. Others feel other nerves need to be affected. I do not think with current technology it is likely that this would have the same impact in the treatment of hypertension as does renal denervation， simply because it is a more costly therapy and one that of course has a greater degree of intervention required.

　　Fink教授：现在人们已经在大量高血压患者中开展了有关颈动脉压力激活疗法的研究。肾脏去神经术可通过导管在相对较短时间内完成，与之不同，颈动脉压力激活疗法需在患者的颈动脉窦周围植入电极，然后让患者佩戴类似起搏器的刺激器，故有创性更大。据我所知，目前有关颈动脉压力激活疗法的试验已开展了至少一年或两年，现有结果提示其能降低交感神经活性，从而发挥长期持续的显著降压作用。颈动脉压力激活疗法确切作用机制尚不清楚，但非常肯定的是抑制交感神经是其非常重要的一个作用机制。但是，目前尚不清楚应用颈动脉压力激活疗法时是否所有的交感神经被同等程度的抑制。有些人认为只需要对肾交感神经进行抑制即可，有些人则认为还需要对其他交感神经进行抑制。目前来说，我认为颈动脉压力激活疗法尚无法像肾脏去神经术那样被用于治疗高血压，因为其成本更高，有创性更大。

上一页  [1]  [2]  [3]  [4]  下一页