肾动脉狭窄介入治疗的疗效分析

Therapeutic effect of renal artery revascularization on renal artery stenosis

  • 摘要: 目的 评价经皮肾动脉成形术血运重建对于肾动脉狭窄患者的血压、肾功能等方面的影响。方法 2004年2月-2008年4月我院收治的肾动脉狭窄患者201例(管腔狭窄≥70%),经肾动脉成形术重建肾动脉血运。其中138例患者术后平均随访(13±10)月,观察其血压、降压药物、肾功能的变化。结果 201例患者肾动脉成形术成功率96%。病变动脉管腔直径狭窄率由70%±11%降至12%±10%。术后随访138例患者血压下降有统计学意义(P<0.01),收缩压由(20.1±3.3)kPa降至(18.3±2.1)kPa,舒张压由(10.9±2.0)kPa降至(10.3±1.5)kPa;口服降压药品种减少(P<0.01),由平均(2.4±1.2)种降至(1.8±0.9)种;术后1至23个月发生支架内再狭窄14例,非开口病变是再狭窄的危险因素。结论 肾动脉狭窄患者经皮肾动脉成形术的手术成功率高,并有助于此类患者血压的长期控制,支架内再狭窄与肾动脉狭窄病变部位相关。

     

    Abstract: Objective To observe the effect of renal artery angioplasty on blood pressure and kidney function in patients with renal artery stenosis(RAS). Methods A total of 201 patients with RAS received percutaneous transluminal renal artery angioplasty/stents(PTRAS). One hundred and thirty-eight patients were followed up for an average period of 13±10 months to observe changes occurred in their blood pressure,serum creatinine level,and glomerular filtration. Results Renal artery angioplasty was successfully performed in 96% of the 201 patients. The renal artery stenosis rate was decreased from 70%±11% to 12%±10% after PTRAS. The blood pressure of 138 followed-up patients was significantly decreased(P<0.01). The number of anti-hypertensive drugs was significantly decreased(P<0.01). The systolic blood pressure was decreased from(20.1±3.3) kPa to(18.3±2.1) kPa,while the diastolic systoli pressure was decreased from(10.9±2.010) kPa to(3±1.5) kPa. Instent restenosis occurred in 14 patients 1 to 23 months after operation,which was correlated with nonostial stenosis. Conclusion Patients with renal artery stenosis can benefit from PTRAS and instent restenosis is correlated with the type of RAS.

     

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