移植肾动脉血流峰值速度加快与移植肾动脉狭窄相关性研究  

Correlative study on relationship between elevated transplant renal artery velocities and transplant renal artery stenosis

作　　者：蔡治涛[1] 刘宏[1] 吴雄飞[1] 

机构地区：[1]第三军医大学第一附属医院肾科,重庆400038

出　　处：《临床泌尿外科杂志》2014年第5期410-412,共3页Journal of Clinical Urology

摘　　要：目的：探讨肾移植术后半年内移植肾动脉血流峰值速度加快与移植肾动脉狭窄相关性。方法：回顾性分析我院102例肾移植患者术后半年内移植肾多普勒超声图像检查结果及临床资料，比较患者收缩期血流峰值速度（PSV）、血压及移植肾功能。结果：102例患者中，有27例患者出现较高的PSV，其中4例患者呈现持续性PSV升高，经行移植肾动脉造影检查而确诊为移植肾动脉狭窄（TRAS），行经皮肾动脉支架植入术（PTRAS）后，PSV降至正常，血压恢复正常，随访6～13个月未见狭窄复发。结论：在肾移植术后半年内，移植。肾动脉PSV加快未必是肾动脉狭窄，可先随访观察，若超声提示PSV呈持续性升高，尤其是伴顽固性高血压，则需行移植肾动脉造影明确是否是TRAS。PTRAS是TRAS安全有效的治疗方法。Objective： To explore the correlation between elevated transplant renal artery velocities and trans- plant renal artery stenosis in patients undergoing transplantation six months postoperatively. Method： The doppler ultrasound image examination, clinical data and follow-up results of 102 patients undergoing renal transplantation in recent five years were reviewed retrospectively. We compared the peak systolic velocity （PSV）, blood pressure and graft function of all patients. Result： In 102 patients, there were 27 cases experienced high PSV, including four cases with persistent increased PSV. These four patients had been diagnosed with transplant renal artery ste- nosis （TRAS） through the transplant renal artery angiography, and then underwent percutaneous transluminal re- nal artery stenting （PTRAS）. PSV and blood pressure returned to normal after the operation. No recurrence of stenosis in the following six to thirteen months follow-up period was detected. Conclusion： The transplant renal artery blood flow velocity may not be a symbol of TRAS within six months after renal transplantation. Regular follow-up plan ia regarded as a primary treatment measure when doppler ultrasound reveals persistent increased PSV, especially associated with resistant hypertension. Angiography is necessary for diagnosis of TRAS. Further- more, PTRAS is a safe and effective choice for the treatment of TRAS.

关 键 词：肾移植 肾动脉狭窄 血流峰值速度 

分 类 号：R699.3[医药卫生—泌尿科学]