高血压患者动脉粥样硬化性肾动脉狭窄临床特征分析  

Characteristic analysis for hypertensive patients with atherosclerotic renal arterial stenosis

作　　者：唐可[1] 赵峰[1] 沈彬[1] 万军平[1] 蒋逸风[1] 

机构地区：[1]解放军第411医院心血管内科,上海200081

出　　处：《临床军医杂志》2014年第2期116-120,共5页Clinical Journal of Medical Officers

摘　　要：目的探讨患有动脉粥样硬化性肾动脉狭窄(ARAS)的高血压患者的临床特征。方法对78例临床怀疑ARAS的高血压患者进行三维动态增强磁共振血管成像(3D DEC-MRA)检查,并检测动态血压、颈动脉内膜中层厚度、血脂、空腹与餐后2 h血糖及尿酸。根据肾动脉3D DEC-MRA结果将78例患者分为ARAS组与非ARAS组,并对两组的临床相关指标进行比较,再将78例患者根据血糖水平分为糖尿病及非糖尿病亚组,并进一步分析比较ARAS与非ARAS患者的临床相关指标。结果非ARAS组患者44例,ARAS组患者34例,与非ARAS组相比ARAS组脉压与尿酸水平显著升高,其中非糖尿病亚组,ARAS患者脉压与餐后2 h血糖水平同样显著高于非ARAS患者。结论 ARAS患者具有更高的脉压、尿酸及餐后血糖水平等临床特征,对具备上述特征的高血压患者筛查ARAS并采取相关治疗具有临床意义。Objective To investigate the clinical characters of atherosclerotic renal arterial stenosis （ARAS） in the patients with hypertension. Methods Three-dimensional dynamic contrast enhanced magnetic resonance angiography （3D DCE-MRA） was used in 78 hypertensive patients suspected of ARAS. Other risk factors such as age, ambulatory blood pressure, carotid intima-medial thickness （IMT） , serum glucose, uric acid and lipid spectrum were also assessed. The patients were divided into ARAS group and non-ARAS group according to the findings of 3D DCE-MRA. Clinical characters were compared between the two groups. All the subjects were then divided into diabetic subgroup and non-diabetic subgroup on the basis of serum glucose level. Such clinical characters were compared between ARAS cases and non-ARAS cases forwardly. Results Pulse pressure and serum uric acid were significantly higher in the patients with ARAS （n = 34 ） than in those without ARAS （n = 44）. In the nondiabetic group, pulse pressure and postprandial 2-hour glucose were significantly higher in the patients with ARAS than in those without ARAS. Conclusion Patients with ARAS are characterized by higher pulse pressure, serum uric acid and postprandial glucose. Screening for ARAS in hypertensive patients with such characters and adopting correlative therapeutic strategies may be of clinical significance.

关 键 词：磁共振血管成像 动脉粥样硬化性.肾动脉狭窄 脉压 尿酸 餐后血糖 

分 类 号：R445.2[医药卫生—影像医学与核医学]