肾素与动脉粥样硬化性肾动脉狭窄支架术预后相关性研究  

Study of the Correlation between Renin and the Prognosis of Atherosclerotic Renal Artery Stenting

作　　者：朱海龙[1] 陈光辉[1] 孙志军[1] 蒋博[1] 王峙峰[1] 王锦达[1] 

机构地区：[1]解放军总医院心血管内科,北京100853

出　　处：《现代生物医学进展》2013年第15期2879-2882,2892,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81270272)

摘　　要：目的:评价下腔静脉肾素活性与动脉粥样硬化性肾动脉狭窄支架植入术后血压及肾功能的相关性。方法:选取我院2007年至2011年49例单侧或者双侧动脉硬化性肾动脉狭窄(ARAS)患者(狭窄程度>70%),成功进行血运重建术;记录患者术前动脉粥样硬化相关危险因素;测量并记录术前及术后患者肾素、血管紧张素、醛固酮、血压、抗血压药物数量、肌酐,并对患者血压及肌酐进行1、3、12月随访观察,评价肾素水平与支架术后血压及肾功能的相关性。结果:根据患者术前与术后下腔静脉肾素水平下降值分为>3 ng/ml/h组和<3 ng/ml/h组,平均随访12个月,观察到肾动脉支架术后患者血压、肾素、血管紧张素、醛固酮均有明显改善,并趋于稳定;两组肌酐肾小球滤过率存在明显差异,分别为第1月随访(52.1±17.7 ml/min和38.3±17.5 ml/min P<0.05)第3月随访(53.1±21.6 ml/min和41.7±16.6 ml/min P<0.05)第12月随访(51.7±19.0 ml/min和41.9±20.7 ml/min P<0.05);肾素水平下降值>3 ng/ml/h组较<3 ng/ml/h组血压及肾功能改善较明显。结论:肾素水平与动脉粥样硬化性肾动脉狭窄支架术后血压及肾功能改善有相关性。Objective： To To evaluate the Correlation between Renin and the Prognosis of Atherosclerotic Renal Artery Stenting.Methods： 49 pts with unilateral or bilateral atherosclerotic renal artery stenosis（ARAS） in our hospital between 2007-2011 undergoing renal artery PTRA were enrolled.Clinical character were got as usual.Pre-and postoperative blood samples were collected,and rennin activity,angiotensin and aldosterone level were measured.In the one year follow-up,blood pressure and serum creatinine were measured and compared with the baseline.Results： The serum rennin activity,angiotensin,and aldosterone level were significantly improved after the treatment.Based on the decrease value of venous renin levels which is defined as the preoperative value minus the postoperative value,patients were divided into 3 ng/ml/h group and 3 ng/ml/h group.In the one year follow-up,the eGFR was obviously different between the two groups,which in the first month（52.1±17.7 ml/min and 38.3±17.5 ml/min,P 0.05） the third month（53.1±21.6 ml/ min and 41.7±16.6 ml/min,P0.05） and the one year（51.7±19.0 ml/min and 41.9±20.7 ml/min,P0.05） respectively.Conclusions： Renin levels may have correlation for the improvement of renal function of patients with serious atherosclerotic renal artery stenosis after PTRA.

关 键 词：动脉粥样硬化性肾动脉狭窄 肌酐 肾素 肾小球率过滤 

分 类 号：R543.6[医药卫生—心血管疾病] R692.16[医药卫生—内科学]