支架重建血运治疗肾动脉狭窄初步结果  

Preliminary results of stenting revascularization as treatment for renal artery stenosis

作　　者：蒋雄京[1] 明广华[1] 吴海英[1] 王蕾礼[1] 王静[1] 郑德裕[1] 刘国仗[1] 刘力生[1] 

机构地区：[1]中国医学科学院,中国协和医科大学阜外心血管病医院,内科高血压研究室,北京100037

出　　处：《中华内科杂志》2002年第2期82-85,共4页Chinese Journal of Internal Medicine

摘　　要：目的　评估支架重建血运治疗肾动脉狭窄的安全性与近期疗效。方法　 30例肾动脉狭窄的患者因严重高血压或伴有肾功能不全而进行了肾动脉支架置放术 (PTRAS) ,并随诊 3个月 ,观察手术对患者血压、肾功能的影响。结果　 30例患者中 ,PTRAS成功 2 9例 (96 7% ) ;至 3个月随诊时 ,患者血压明显下降 (P <0 0 0 1) ,收缩压从 173 5mmHg(1mmHg =0 133kPa)降至 135 8mmHg,舒张压从 95 8mmHg降至 75 6mmHg,患者服用降压药物种类明显减少 (从平均 2 5种减至 1 5种 ,P <0 0 0 1) ;其中 5例 (16 7% )治愈 ,2 2例 (73 3% )改善 ,3例 (10 % )无效 ;血肌酐 2例 (6 7% )轻度下降 ,2 8例 (93 3% )无变化。Objectives To evaluate the safety and short-term efficacy of stent revascularization as treatment for renal artery stenosis. Methods Percutaneous transluminal renal angioplasty with stent (PTRAS) was performed on 30 consecutive patients with severe renal artery stenosis for poorly controlled hypertension or preservation of renal function. They subsequently underwent 3 -month clinical follow-up for the effect of the procedure on renal function, blood pressure control and the number of antihypertensive medications used. Results Angiographic success was obtained in 29 (96.7%) of the 30 patients after PTRAS. 3 months after the procedure systolic and diastolic blood pressures significantly decreased (from 173.5 to 135.8 mm Hg and from 95.8 to 75.6 mm Hg, respectively; P<0.001) and less antihypertensive medications were taken (from 2.5 to 1.5). Blood pressure in 5 (16.7%) of the 30 patients became normal without taking any antihypertensive medication and blood pressure control was more facile in 22 (73.3%) of the patients. However, there was no improvement in 3 (10.0%) of the patients. Creatinine slightly decreased in 2 (6.7%) of the 30 patients and remained stable in 28 (93.3%) of the 30 patients. There was no statistical significance in this respect. Conclusions Renal artery stent revascularization has a short-term beneficial effect on blood pressure control and a nondeleterious effect on renal function. The long-term efficacy should be investigated. The procedure is safe in usual.

关 键 词：肾动脉梗阻 支架 高血压 肾功能衰竭 肾动脉狭窄 PTRAS 

分 类 号：R543.5[医药卫生—心血管疾病]