肾动脉狭窄支架术后长期疗效相关危险因素分析  

Risk factors related to long-term curative effect after renal artery stenting for renal artery stenosis

作　　者：杨静[1] 蒋博[1] 盖鲁粤[1] 刘宏斌[1] 陈练[1] 朱海龙[1] 孙志军[1] 

机构地区：[1]解放军总医院心血管内科,北京100086

出　　处：《中国循证心血管医学杂志》2012年第6期552-553,共2页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨影响肾动脉狭窄患者支架治疗术疗效的相关因素。方法纳入192例行肾动脉支架置入术治疗的肾动脉狭窄患者,随访血压、血肌酐变化及全因死亡情况,筛选肾功能恶化和死亡的预测指标。结果随访期间患者的血压水平较术前明显下降(P<0.01),血肌酐水平升高(P<0.05)。所纳入病例的全因死亡率为11%。Logistic回归分析显示高龄[比值比(OR)=1.11]和术前肌酐水平偏高(OR=1.007)是全因死亡的预测因素;高龄(OR=2.32)、糖尿病(OR=1.45)、术前肌酐水平偏高(OR=7.1)是肾动脉支架术后肾功能恶化的预测因素。结论肾动脉狭窄支架术治疗动脉粥样硬化性肾动脉狭窄疗效和安全性良好,高龄、术前肌酐水平偏高和合并糖尿病是肾动脉支架术后预后不良的危险因素。Objective To analyze the relative factors influencing the curative effect of renal artery stenting in the patients with atherosclerotic renal artery stenosis （ ARAS ） . Methods ARAS patients （ n =192 ） treated with renal artery stenting were selected and theire changes of blood pressure and serum creatinine （ Cr ） and all- cause mortality were followed up, and predictive indicators for renal function deterioration and mortality were screened. Results During the follow-up period, the level of blood pressure decreased significantly （ P 0.01 ） and serum Cr increased （ P 0.05 ） after the stenting, and all-cause mortality was 11% in the patients. Logistic regression analysis showed that advanced age （ OR =1.11 ） and higher pre-operation Cr （ OR =1.007 ） were the predictive indicators for all-cause mortality, and advanced age （ OR =2.32 ） , diabetes （ OR =1.45 ） and higher pre-operation Cr （ OR =7.1 ） were the predictive indicators for renal function deterioration after renal artery stenting. Conclusion The curative effect and safety of renal artery stenting are higher for treating ARAS, and advanced age, higher pre-operation Cr and diabetes all are risk factors of poor prognosis.

关 键 词：动脉粥样硬化性肾动脉狭窄 肾血管性高血压 肾动脉支架术 

分 类 号：R543.5[医药卫生—心血管疾病]