肾动脉狭窄发生一过性肺水肿的机制  

Mechanism of Renal Artery Stenosis and Flash Pulmonary Edema

作　　者：段芹[1,2] 张冬颖[1,2] 覃数[1,2] 

机构地区：[1]重庆医科大学 [2]重庆医科大学附属第一医院心内科,重庆400016

出　　处：《心血管病学进展》2012年第3期393-395,共3页Advances in Cardiovascular Diseases

摘　　要：一过性肺水肿是急性失代偿性心力衰竭中进展尤其迅速的一种特殊类型,它具有区别于其他急性失代偿性心力衰竭的独特的病理生理特征。肾动脉狭窄是一过性肺水肿的一种可逆病因,经肾血管血运重建可很好控制肺水肿的复发,并对肾血管性高血压和肾功能有一定的改善作用。单侧或双侧肾动脉狭窄者都可发生一过性肺水肿,其中以双侧狭窄发病为多见。目前认为,肾动脉狭窄发生一过性肺水肿的病理机制与肾素血管紧张素系统的激活,压力排尿机制受损和肺毛细血管气血屏障受损有关,外科手术或经皮肾动脉血运重建技术都已成功被证明可用于治疗肾动脉狭窄发生一过性肺水肿的患者。Flash pulmonary oedema(FPO) is a particularly dramatic form of acute decompensates heart failure.Renal stenosis is one reversible reason of FPO in these patients,and the successful revascularization of renal arteries could well control the recurrence of FPO.Although unilateral and bilateral renal stenosis may combine with FPO,and the bilateral ones are more frequent.Renal stenosis patients predisposes to develop FPO by three main pathophysiological mechanisms: defective natriuresis,activation of the renin-angiotensin-aldosterone system,and failure of the pulmonary capillary blood-gas barrier.Both surgical and percutaneous revascularization technique have been successful in treating renal artery stenosis and its clinical manifestation such as FPO.

关 键 词：肾动脉狭窄 一过性肺水肿 机制 

分 类 号：R692.9[医药卫生—泌尿科学]