移植肾动脉狭窄的早期诊治策略及疗效评价  

Early diagnosis and treatment evaluation on patients with transplant renal artery stenosis

作　　者：王锁刚[1] 陈铸[1] 骈林萍[2] 苗牛[3] 程留慧[4] 崔勇[1] 何伟[1] 王光策[1] 

机构地区：[1]河南中医学院第一附属医院泌尿外科肾移植科,郑州450003 [2]河南中医学院第一附属医院超声科,郑州450003 [3]河南中医学院第一附属医院介入科,郑州450003 [4]河南中医学院第一附属医院放射科,郑州450003

出　　处：《肾脏病与透析肾移植杂志》2015年第1期16-20,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的:探讨移植肾动脉狭窄(TRAS)的早期诊断、治疗策略和预后,评价综合治疗TRAS的临床效果及安全性。方法:回顾性分析6例TRAS患者临床资料,总结其临床特点、诊断、疗效、并发症及转归等。结果:TRAS以顽固性高血压、肾功能异常、尿少和移植肾区血管杂音为主要临床特点;TRAS的早期诊断主要依据彩色多普勒血流显像(CDFI)和双源CT三维血管成像(DSCTA)。本组患者全部治疗成功,无一例出现严重并发症。随访期间,所有患者肾功能正常,血压稳定,生活质量良好。结论:早期诊断TRAS,并选择合理的综合治疗方案,对逆转TRAS导致的顽固性高血压和移植肾功能损害,提高移植人/肾的生存率有重要意义。Objective ：To investigate the strategy of early diagnosis, therapy and prognosis of transplant renal artery stenosis （TRAS）, and to further evaluate the clinical curative eflicacy and safety of TRAS with comprehensive care. Methodology ：The clinical data of six cases with TRAS were analyzed retrospectively. The clinical characteristics and diagnosis of TRAS,therapeutic effects, complications, and outcomes were summaried. Results： The clinicalfeatures in patients with TRAS were resistant hypertension, kidney dysfunction, olignria and transplant renal vascular murmur. The early diagnosis of TRAS mainly depends on color Doppler flow imaging （CDFI） and Dual-Source CT angiography （DSCTA）. The treatment success rate was 100%, no severe complications were found in all the cases, and comprehensive therapy was satisfactory. During the follow-up period, all of patients with normal renal function, stable blood pressure, and living quality was good. Conclusion： Early diagnosis and appropriately comprehensive therapy play important role in reversing resistant hypertension and transplant renal damage caused by TRAS, which may contribute significantly to patients and allograft survival.

关 键 词：移植肾动脉狭窄 彩色多普勒血流显像 双源CT三维血管成像 综合治疗 

分 类 号：R699.2[医药卫生—泌尿科学]