肾动脉支架置入术治疗动脉粥样硬化性肾动脉狭窄273例疗效分析  

Curative effect of renal artery stenting on patients with atherosclerotic renal artery stenosis: An analysis of 273 cases

作　　者：刘继轩 陈光辉[1] 孙志军[1] 蒋博[1] 王锦达[1] 

机构地区：[1]解放军总医院心血管内科,北京100853

出　　处：《解放军医学院学报》2016年第5期425-428,共4页Academic Journal of Chinese PLA Medical School

基　　金：国家自然科学基金项目(81270272)~~

摘　　要：目的对肾动脉支架置入术(percutaneous renal artery stent implantation,PTRAS)治疗动脉粥样硬化性肾动脉狭窄(atherosclerotic renal artery stenosis,ARAS)的疗效进行分析。方法纳入2008年1月-2015年4月于本院住院的273例单侧或双侧肾动脉狭窄≥70%的患者。均经股动脉或桡动脉途径行肾动脉支架置入术,并定期随访6个月,观察血压、降压药物和肾功能的变化情况。结果 273例中高血压治愈33.3%(91/273)、改善58.2%(159/273)、无效8.5%(23/273)。6个月后患者血压得到改善[6个月后收缩压(137±17)mm Hg(1 mm Hg=0.133 k Pa)、舒张压(84±8)mm Hg vs术前收缩压(163±19)mm Hg、舒张压(93±12)mm Hg,P<0.05]。术后6个月服用降压药种类较术前减少(2.0±0.4 vs 2.7±1.3,P<0.05)。术后6个月患者血肌酐较术前稍有升高[(122.7±61.3)μmol/L vs(121.3±60.5)μmol/L,P>0.05]。术后6个月肾小球滤过率较术前稍有降低(70.2±19.5 vs 70.5±18.8,P>0.05)。结论支架置入术治疗动脉粥样硬化性肾动脉狭窄疗效确切,可有效控制患者血压,但对肾功能无确切保护作用。Objective To analyze the clinical efficacy of percutaneous renal artery stenting（PTARS） on patients with atherosclerotic renal artery stenosis（ARAS）. Methods The study included 273 patients with unilateral or bilateral renal artery stenosis≥70% who were hospitalized in our hospital from January 2008 to April 2015. Renal artery stenting was performed through femoral artery or radial artery. The changes of blood pressure, drugs and renal function were observed in a 6-month follow-up.Results Of the 273 cases, as for hypertension, 91 patients（33.3%） were cured, 159 cases（58.2%） were improved, and invalid was found in 23 cases（8.5%）. Six months after stenting, the blood pressure of patients were significantly lower than preoperative stage [systolic pressure：（137±17） mm Hg vs（163±19） mm Hg, diastolic pressure：（84±8） mm Hg vs（93±12） mm Hg, P〈0.05], the categories of antihypertensive drugs were significantly less than preoperative [（2.0±0.4） vs（2.7±1.3）, P〈0.05], while the serum creatinine and glomerular filtration rate did not significantly changed [（121.3±60.5）μmol/L vs（122.7±61.3）μmol/L, P〉0.05;（70.2±19.5） ml/min vs（70.5±18.8） ml/min, P〉0.05]. Conclusion Stent implantation is effective in the treatment of ARAS, which decreases the blood pressure of patients and makes it easier to be controlled, but it does not have any exactly protective effect on renal function.

关 键 词：动脉粥样硬化性肾动脉狭窄 支架置入术 高血压 

分 类 号：R543.5[医药卫生—心血管疾病]