姑息性肾动脉成形术用于严重冠心病合并肾动脉狭窄老年患者  

Palliative percutaneous transluminal renal angioplasty and stenting in elderly patients for serious coronary heart disease with renal arterial stenosis

作　　者：耿庆山[1] 周颖玲[1] 黄文晖[1] 罗建方 赵洪磊[1] 陈纪言[1] 

机构地区：[1]广东省心血管病研究所心内科,广东广州510080

出　　处：《第一军医大学学报》2005年第7期912-913,共2页Journal of First Military Medical University

摘　　要：目的探讨对严重冠心病合并肾动脉狭窄的老年病人姑息性单纯行肾动脉成形术及支架植入术(PTRA)的可行性。方法选取2000年7月￣2003年7月间严重冠心病合并肾动脉狭窄的未行冠脉搭桥及经皮冠脉成形术且单纯行PTRA治疗的病人共34例(男23人、女11人),并对病人心肾功能、心脏超声心动图观察左室射血分数(LVEF)以及SF-36调查表内容进行17￣53个月[平均(35.0±9.3)月]的随访。结果随访中心绞痛发作次数由每周(14.0±3.9)次发展为6.5±3.3次(P<0.01),LVEF从(40.2±10.4)%发展为(45.3±7.8)%(P<0.05);SF-36调查表中评分总分由56.5±8.0好转为80.1±16.8(P<0.01),评分中的健康和日常活动、自我感觉、总的健康情况部分也有明显好转(P<0.01)。结论严重冠心病合并肾动脉狭窄病人,如病人按目前条件不能行冠脉搭桥或冠脉成形术,姑息性单纯行PTRA是必要且可行的方法。Objective To investigate the feasibility of palliative percutaneous transluminal renal angioplasty (PTRA) and stenting in patients with serious coronary heart disease and renal arterial stenosis.Methods Thirty-four (23 male and 11 female) patients with a mean age of 61.0±11.8 years (ranging from 55 to 78 years) with serious coronary heart disease and renal arterial stenosis,who were unwilling or not suitable to undergo percutaneous coronary intervention and coronary artery bypass grafting,were enrolled in this study.All the cases underwent PTRA and were followed up for 17-53 months (average 35.0±9.3 months).The patients' renal and cardiac functions and left ventricular ejection fraction (LVEF) were measured in transthoracic echocardiography with the score of SF-36 Health Survey recorded.Results During the follow-up,the weekly incidence of angina pectoris reduced from 14.0±3.9 to 6.5±3.3 (P<0.01) and LVEF increased from (40.2±10.4)% to (45.3±7.8)% (P<0.05).The SF-36 scores were significantly improved from 56.5±8.0 to 80.1±16.8 (P<0.01),with also significant improvement in the subscales of health and daily activity,self-feeling,and general health.Conclusion Palliative PTRA and stenting is feasible and necessary in elderly patients with serious coronary heart disease and renal arterial stenosis when percutaneous coronary intervention or coronary artery bypass graft therapy is not possible.

关 键 词：冠状动脉疾病 肾动脉狭窄 血管成形术 支架植入术 

分 类 号：R541.4[医药卫生—心血管疾病]