高血压合并肾动脉狭窄患者肾动脉支架术对血压的影响  

Blood Pressure After the Renal Artery Stenting in Hypertensive Patients with Atherosclerosis Renovascular Disease

作　　者：王焱[1] 巩燕[1] 叶涛[1] 郑剑涛[1] 黄卫斌[1] 江宏飞[1] 陈炳煌[1] 陈水龙[1] 何世华[1] 

机构地区：[1]厦门大学附属中山医院厦门心脏中心,福建厦门361000

出　　处：《中华高血压杂志》2006年第8期613-616,共4页Chinese Journal of Hypertension

摘　　要：目的评估肾动脉支架术对高血压合并肾动脉狭窄患者血压的影响。方法对患有高血压的67例肾动脉明显狭窄(管腔内径减少≥70%)的患者行肾动脉支架植入术(PTRAS),术后行血压及血肌酐(SCr)的长期随访。结果患者67例植入77枚支架均获成功。所有患者均随访血压及肾功能,平均随访时间(18±6)月,随访患者的收缩压由(171±23)下降至(160±20)mmHg,P<0.05,舒张压由(95±14)下降至(85±13)mmHg,P<0.01;降压药物的种类显著减少[由(2.7±1.6)下降至(1.9±1.4)种,P<0.01]。术前肾功能正常者(SCr<130μmol/L)术后血压下降最为显著[收缩压由(176±33)下降至(159±26)mmHg,P<0.01,舒张压由(98±15)下降至(83±15)mmHg,P<0.01]。而术前肾功能受损者(130≤SCr≤350μmol/L)术后血压无明显改变。术后随访血肌酐及肾小球滤过率较术前无明显改变。结论肾动脉支架植入术有助于肾功能正常的高血压患者血压控制。Objective To evaluate the changes in blood pressure after the renal artery angioplasty and stenting in patients with atherosclerosis renovascular disease with hypertension. Methods Percutaneous renal artery stent （PTRAS） were performed in 67 patients with renal artery stenosis （≥ 70Y00 ）. Long term （18± 6 months） blood pressure and serum creatinine were followed-up in all patients. Results Seventy seven stents were successfully deposited in 77 lesions of 67 consecutive patients. Systolic and diastolic pressure were significantly decreased from 171 ± 23 to 160± 20 mm Hg （ P〈0.05 ） and from 95 ± 14 to 85-b13 mm Hg（P〈0.01）. The number of anti-hypertension medications were significantly decreased from 2.7±1.6 to 1.9± 1.4, P〈0.01. Blood pressure was well controlled among patients with normal serum creatinine, but not in patients with serum creatinine≥130 μmol/L. Serum creatitine level and glomerular filtration rate（GFR） did not change significantly after the treatment. Conclusion Hypertensive patients with renal artery stenosis were benefited by implantation of renal artery stent, especially in the patients with normal kidney function.

关 键 词：肾动脉狭窄 高血压 支架 

分 类 号：R544.1[医药卫生—心血管疾病]