经皮肾动脉介入治疗对肾动脉狭窄患者心功能的影响  

Clinical effect of percutaneous renal artery intervention on heart function in patients with renal artery stenosis

作　　者：李明琰[1] 崔永生[1] 何文凯[1] 赵磊[1] 邓秀芳[1] 王玉婷[1] 

机构地区：[1]广州医科大学附属第四医院心内科,广州511447

出　　处：《岭南心血管病杂志》2016年第4期449-453,共5页South China Journal of Cardiovascular Diseases

基　　金：国家自然科学基金(青年基金项目)HIF-1α突变体对缺血心肌血管生成和心功能影响的研究(项目编号:81300086)

摘　　要：目的评价经皮肾动脉介入(percutaneous renal artery intervention,PRAI)治疗对肾动脉狭窄患者心功能的影响。方法对诊断为肾动脉狭窄的54例患者,根据是否行PRAI分为PRAI组(A组,n=30例)和药物治疗组(B组,n=24例)。记录术前1年及术后1年Pickering综合征发作次数;术前及术后1年行血压测量、心脏超声检查、6 min步行试验。对比两组血压控制情况,Pickering综合征发作次数.心脏功能变化情况。结果术后1年,与常规药物治疗组对比,PRAI组收缩压、舒张压、脉压明显降低,降压药使用减少,差异有统计学意义(P<0.05);Pickering综合征发作明显得以控制;射血分数、E/A、左心室舒张末期内径、左心室收缩末期内径改善,6 min步行距离增加差异有统计学意义(P<0.05)。结论 PRAI治疗有利于血压控制,减少降压药的使用,有效预防Pickering综合征的发作,改善心脏功能,有良好的远期效果。Objectives To evaluate the effect of percutaneous renal artery intervention （PRAI） treatment on cardiac function in patients with renal artery stenosis. Methods A total of 54 patients diagnosised as athrosclerotic renal artery stenosis were divided into two groups based on different treatments： group A received PRAI （n=30） and group B received drug treatment （n=24）. We recorded the frequency of Picketing syndrome attacks and the kinds of anti- hypertensive drugs needed, measured the blood pressure, as well as assessed the cardiac function by cardiac ultrasound and the 6-minute walking test before and 12 months after PRAI or drug treatment. These indexes were compared between the two groups. Results Compared with group B 12 months after treatment, systolic pressure, diastolic pressure, pulse pressure and the kinds of anti-hypertensive drugs reduced more outstandingly in group A （P〈0.05）. PRAI controlled the onset of Picketing syndrome more effectively. The values of cardiac ultrasound [ EF, E/A, left ventricular end-diastolic dimension （LVEDD）, left ventricular end-systolic dimension （LVESD）] and the result of 6- minute walking test of group A were better than those of group B （P〈0.05）. Conclusions PRAI is conducive to control the blood pressure, reduce the use of anti-hypertensive drugs, prevent the onset of Picketing syndrome and improve the heart function, which can lead to a better long-term effect.

关 键 词：肾动脉狭窄 经皮肾动脉介入治疗 Pickering综合征 心功能 

分 类 号：R543[医药卫生—心血管疾病]