动脉硬化性肾动脉狭窄行经皮肾动脉成形支架植入术后临床疗效分析  

Clinical efficacy of percutaneous transluminal renal angioplasty with stent placement in the treatment of atherosclerotic renal artery stenosis

作　　者：廖传军[1] 张望德[1] 

机构地区：[1]首都医科大学附属北京朝阳医院血管外科,北京100020

出　　处：《中华老年多器官疾病杂志》2016年第3期182-185,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的探讨经皮肾动脉成形支架植入术在治疗动脉硬化性肾动脉狭窄时对患者血压和肾功能的影响。方法2010ff7月至2013年7月共有48例动脉硬化性肾动脉狭窄患者行肾动脉成形支架植入术，根据其术前肾功能情况将患者分为两组，A组患者（20例）术前估测肾小球滤过率（eGFR）〈60ml／（min·1．73m2），B组患者（28例）术前eGFR≥60ml／（min·1．73m2）。结果48例患者共植入了52个支架，随访24个月，患者的收缩压和舒张压较术前明显下降，差异具有统计学意义（P〈0．05）。A组患者的术后eGFR较术前明显升高，差异具有统计学意义（P〈0．05）。结论肾动脉成形支架植入术对于动脉硬化性肾动脉狭窄患者是一种安全有效的治疗方法，可有效降低患者血压，术前已经出现轻中度肾功能损害的患者术后肾功能得到明显改善。Objective To determine the effect of percutaneous transluminal renal angioplasty with stent placement （PTRAS） in the treatment of atherosclerotic renal artery stenosis （ARAS）. Methods A total of 48 ARAS patients admitted in our department from July 2010 to July 2013 were enrolled in this study. According to the pre-operative estimated glomerular filtration rate （eGFR）, they were divided into group A [eGFR 〈 60ml/（min · 1.73m2）, n = 20] and group B [eGFR≥ 60ml/（min · 1.73m2）, n = 28], and all underwent PTRAS. Results There were 52 stents placed in the 48 ARAS patients. In 24 months of follow-up, their systolic and diastolic blood pressure were significantly reduced after operation （P 〈 0.05）. The patients of group A had their eGFR obviously increased when compared with the rate before surgery （P 〈 0.05）. Conclusion PTRAS is a safe and effective procedure for ARAS patients. It can effectively reduce blood pressure, and even improve the renal function for those whose renal function has already been mildly or moderately impaired.

关 键 词：肾动脉狭窄 经皮肾动脉成形术 肾血管性高血压 估测肾小球滤过率 

分 类 号：R654.4[医药卫生—外科学]