由陳紹良等進(jìn)行的一項研究表明，在藥物治療反應(yīng)不佳的特發(fā)性肺動脈高壓（IPAH）患者中，肺動脈去神經(jīng)術(shù)（PADN）可對功能能力和血流動力學(xué)指標(biāo)產(chǎn)生積極影響,。論文發(fā)表于7月的《美國心臟病學(xué)會雜志》（JACC）電子版。
此項研究共納入21例對藥物治療反應(yīng)不佳的IPAH患者，其中13例接受PADN治療,，另外8例拒絕PAND治療的患者被分入對照組。在主肺動脈分叉以及左,、右肺動脈開口處實施PADN,。主要終點為隨訪3個月時肺動脈壓、三尖瓣偏移（Tei）指數(shù)和6分鐘步行距離（6MWT）變化,。
結(jié)果顯示,，與對照組相比,，隨訪3個月時PADN組患者的平均肺動脈顯著降低（由55±5 mmHg降至36±5 mmHg，P<0.01）,，6MWT（由324±21 m增加至491±38 m,，P<0.006）和Tei指數(shù)（由0.3±0.04升高至0.50±0.04，P<0.001）亦出現(xiàn)顯著改善,。(生物谷Bioon.com)
生物谷推薦英文摘要：
J Am Coll Cardiol doi:10.1016/j.jacc.2013.05.075
Pulmonary artery denervation to treat pulmonary arterial hypertension: a single-center, prospective, first-in-man PADN-1 study ONLINE FIRST
Shao-Liang Chen, MD, FACC; Feng-Fu Zhang, MD; Jing Xu, MD; Du-jiang Xie, MD; Ling Zhou, MD; Thach Nguyen, MD; Gregg W. Stone, MD, FACC
Objectives This study tested the safety and efficacy of pulmonary artery (PA) denervation (PADN) for patients with idiopathic pulmonary artery hypertension (IPAH) not responding optimally to medical therapy.
Background Baroreceptors and sympathetic nerve fibers are localized in or near the bifurcation area of the main PA. We previously demonstrated that PADN completely abolished the experimentally elevated PA pressure responses to occlusion of the left interlobar pulmonary artery.
Methods Out of a total of 21 patients with IPAH, 13 patients received the PADN procedure, the other 8 patients who refused the PADN procedure were assigned to the control group. PADN was performed at the bifurcation of the main PA, and at the ostial right and left PA. Serial echocardiography, right heart catheterization, and a 6-minute walk test (6MWT) were performed. The primary endpoints were the change of pulmonary artery pressure (PAP), tricuspid excursion (Tei) index, and 6MWT at 3-months follow-up.
Results Compared with the control group, at 3 months follow-up, the patients who underwent the PADN procedure showed significant reduction of mean PAP (from 55±5 mmHg to 36±5 mmHg, p<0.01), significant improvement of the 6MWT (from 324±21 m to 491±38 m, p<0.006) and of the Tei index (from 0.3±0.04 to 0.50±0.04, p<0.001).
Conclusion We report for the first time the effect of PADN on functional capacity and hemodynamics in patients with IPAH not responding optimally to medical therapy. Further randomized study is required to confirm the efficacy of PADN.Clinical trial ID: chiCTR-ONC-12002085
