烟雾病合并肾动脉狭窄的临床特征及治疗预后  

Clinical features and prognosis of patients with m oyam oya disease and renal artery stenosis

作　　者：张正善 杨怀滔 张睿 段炼 

机构地区：[1]解放军第三0七医院神经外科,北京100071

出　　处：《中国脑血管病杂志》2015年第4期185-188,共4页Chinese Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金资助项目(81171083);军事医学科学院转化医学基金(2013ZHYX008)

摘　　要：目的探讨烟雾病合并肾动脉狭窄（RAS）的临床特征及治疗预后。方法回顾性分析解放军第三0七医院神经外科2009年3月至2012年6月收治的15例烟雾病合并RAS患者及基线情况匹配的30例无RAS烟雾病患者的首发症状、颅内血管病变情况、肾动脉病变情况、治疗及随访结果等临床资料。结果（1）烟雾病合并RAS 患者占同期收治的烟雾病患者总数的1．6％（15／927）。RAS组左侧RAS有5例，右侧RAS有4例，双侧RAS有6例；轻度狭窄占71．4％（15／21侧），近端狭窄占85．7％（18／21侧）；RAS 组高血压患者（80．0％，12例）显著高于无RAS烟雾病组（30．0％，9例），差异有统计学意义（χ2＝10．045，P ＜0．05）。两组患者铃木分期分布差异有统计学意义（Z ＝－6．184，P ＜0.01）。（2）对RAS行介入治疗的4例，术后血压均下降至正常。介入治疗后造影随访3例，随访时间9～108个月，肾动脉均无再狭窄发生。结论烟雾病RAS患者的高血压患病率较未合并RAS显著升高，并且颅内血管病变程度与未合并RAS患者存在差异。RAS以近端、轻度狭窄为主，血管介入治疗烟雾病合并严重RAS有效，但长期预后需进一步随访。Objective To investigate the clinical features and prognosis of patients with moyamoya disease and renal artery stenosis. Methods The clinical data such as the first symptom,intracranial vascular lesions,renal artery lesions,treatment and follow-up results of the 15 patients with moyamoya disease and complicated with renal artery stenosis （RAS group）and the baseline-matched 30 moyamoya diseased patients without renal artery stenosis （MMD group）treated at the Department of Neurosurgery,the 307 th Hospital of People′s Liberation Army from March 2009 to June 2012 were analyzed retrospectively. Results （1）The moyamoya diseased patients with renal artery stenosis accounted for 1. 6%（15 / 927）of the total number of patients with moyamoya disease admitted in the same period. In the RAS group,the left renal artery stenosis accounted for 5 cases,the right renal artery stenosis accounted for 4 cases,and the bilateral renal artery stenosis accounted for 6 cases. Mild stenosis accounted for 71. 4%（15 / 21 sides）, proximal stenosis accounted for 85. 7% （18 / 21 sides）. The incidence of hypertension （80. 0%,n = 12） of the RAS group was significantly higher than that of the MMD group （30. 0%,n =9）. There was significant difference （χ2 = 10. 045,P ＆lt; 0. 05）. There was significant difference in the distribution of Suzuki stage between the patients of the two groups （Z = -6. 184,P ＆lt;0. 01）. （2）Four patients underwent interventional therapy,their blood pressure decreased to normal level after procedure. Three patients were followed up for 9 months to 108 months with angiography after interventional treatment. No restenosis occurred in renal artery. 〈br〉 Conclusion The incidence of hypertension in patients with RAS is significantly higher than that without RAS,and there is difference between the degree of intracranial vascular lesions and the patients without RAS. Renal artery stenosis is mainly the proximal mild stenosis. Interventional therapy is an effective method for th

关 键 词：脑底异常血管网病 肾动脉梗阻 疾病特征 血管内治疗 

分 类 号：R743[医药卫生—神经病学与精神病学] R692.16[医药卫生—临床医学]