动脉粥样硬化性肾动脉狭窄介入治疗的疗效分析  

Curative effects of interventional therapy on atherosclerotic renal artery stenosis

作　　者：何云[1] 耿召华[1] 张波[1] 赵刚[1] 陈剑飞[1] 周音频[1] 晋军[1] 

机构地区：[1]第三军医大学新桥医院心血管内科,重庆400037

出　　处：《西南国防医药》2013年第7期718-720,共3页Medical Journal of National Defending Forces in Southwest China

基　　金：重庆市科技攻关计划项目(CSTC 2009AB5196);军队临床高新技术重点项目(2010gxjs071)

摘　　要：目的评价介入治疗对动脉粥样硬化性肾动脉狭窄(ARAS)患者的血压、肾功能方面的近期和中期疗效,分析肾动脉狭窄的相关危险因素。方法对2005年1月～2009年4月我院收治的71例ARAS患者进行回顾性分析,分别于术后1个月、1年、2年、3年随访患者,观察患者血压、肾功能改善情况,分析相关危险因素。结果手术成功率97.2%,整体并发症发生率14.1%。术前收缩压(183±19)mmHg,至随访时分别降为(147±12)、(152±14)、(154±17)、(157±16)mmHg(P<0.01);术前舒张压(97±8)mmHg,至随访时分别降为(87±8)、(90±7)、(93±9)、(92±11)mmHg(P<0.01);术前口服降压药平均(2.3±0.8)种,至随访时分别降为(1.6±1.1)、(1.7±0.8)、(1.7±1.0)、(1.8±1.1)种(P<0.01);术前血清肌酐(113.2±70.9)μmol/L,至随访时降为(103.0±65.7)、(97.5±42.5)、(101.8±60.9)、(106.8±53.9)μmol/L(P>0.05)。经Logistic逐步回归分析显示,吸烟、糖尿病和冠心病是ARAS的独立危险因素(OR=7.41、3.17、4.13,P<0.05)。结论经皮肾动脉成形术治疗ARAS的手术成功率高,在近期和中期对控制血压和稳定肾功能均有积极的意义。吸烟、糖尿病和冠心病ARAS的独立危险因素。Objective To evaluate the short-and mid-term curative effects of interventional therapy on the blood pressure and renal function in patients with atherosclerotic renal artery stenosis（ARAS）.Methods A retrospective analysis of clinical data was made in 71 patients with ARAS hospitalized between January 2005 and April 2009.The follow-up was made 1 month,1 year,2,and 3 years after the operation.The improvements in those patients’ blood pressure and renal function were observed,and the risk factors were analyzed.Results The surgical success rate was 97.2%.The incidence of overall complications was 14.1%.The preoperative systolic pressure was（183 ± 19） mmHg,which decreased to（147 ± 12）,（152 ± 14）,（154 ± 17）,（157 ± 16） mmHg at the time of follow-up,respectively（P ＆lt; 0.01）.The preoperative diastolic pressure was（97 ± 8） mmHg,which decreased to（87 ± 8）,（90 ± 7）,（93 ± 9）,（92 ±11） mmHg at the time of follow-up,respectively（P ＆lt;0.01）.The average kinds of orally taken medicine were（2.3 ±0.8） ones,which decreased to（1.6 ± 1.1）,（1.7 ± 0.8）,（1.7 ± 1.0）,（1.8 ± 1.1） at the time of follow-up,respectively（P ＆lt; 0.01）.The preoperative serum creatinine was（113.2 ± 70.9） μmol / L,which decreased to（103.0 ± 65.7）,（97.5 ± 42.5）,（101.8 ± 60.9）,（106.8 ± 53.9） μmol/L at the time of the follow-up,respectively（P ＆lt; 0.01）.The Logistic regression analysis showed that the smoking,diabetes,and coronary heart disease were the independent risk factors of ARAS（OR = 7.41,3.17,and 4.13,P ＆lt; 0.05）.Conclusion The success rate of percutaneous renal artery angioplasty on ARAS is high.This method has positive significance in the short and mid term control of blood pressure and stabilization of renal function.Smoking,diabetes,and coronary heart disease are independent risk factors of ARAS.

关 键 词：动脉粥样硬化 肾动脉狭窄 介入治疗 疗效 

分 类 号：R543.5[医药卫生—心血管疾病]