移植肾功能不全受体肾动脉狭窄的临床分析  

The clinical analysis of renal arterial stenosis of recipients with renal allograft dysfunction

作　　者：廖贵益[1] 唐亮[1] 朱道方[1] 钟金彪 丁汉东[1] 兰天池 杨巧兰[1] Liao Guiyi;Tang Liang;Zhu Daofang;Zhong Jinbiao;Ding Handong;Lan Tianchi;Yang Qiaolan(The First Affiliated Hospital of Anhui Medical University,HeFei 230022,Anhui,China)

机构地区：[1]安徽医科大学第一附属医院泌尿外科肾脏移植病区

出　　处：《实用器官移植电子杂志》2019年第6期469-471,共3页Practical Journal of Organ Transplantation(Electronic Version)

基　　金：安徽省重点研究与开发计划项目（1704a0802173)

摘　　要：目的分析移植肾功能不全受体肾动脉狭窄的发生率、处理方法及处理后的临床效果。方法回顾性分析2018年11月—2019年3月本院52例移植肾功能不全受体的临床资料,主要包括旋转数字减影血管造血(digital subtraction angiography,DSA)检查结果、肾动脉狭窄受体的介入治疗及临床效果。结果52例中24例(46.1%)存在明显肾动脉狭窄,狭窄程度为28%~95%,平均为66.96%。肾动脉狭窄的表现形式:①肾动脉与髂内动脉吻合口狭窄;②肾主动脉或段动脉折曲;③肾主动脉节段性狭窄;④髂内动脉血栓。24例肾动脉狭窄受体中,21例接受介入治疗,1例并发血栓形成至切除移植肾,2例拒绝介入治疗。接受介入治疗的21例中17例(73.9%)1~3周内观察到血肌酐值稳定下降,平均血肌酐值由介入治疗前的269.6μmol/L下降到190.1μmol/L,下降29.5%。结论对于移植肾功能不全的受体,移植肾动脉狭窄是很常见的并发症,要得到重视并常规接受筛查。介入治疗为其首选的处理方法,早发现、早处理能获得一定的临床效果。Objective To analyze the incidence rate,treatment and the clinical effect of renal artery stenosis in patients with renal allograft dysfunction.Methods The clinical data of 52 patients with renal allograft dysfunction in our hospital from November 2018 to March 2019 were reviewed retrospectively.The study mainly included rotational intra-arterial digital subtraction angiography(DSA),interventional treatment of renal artery stenosis and the clinical effects.Results A total number of 24 of 52 cases(46.1%)encountered obvious renal artery stenosis and the degrees of stenosis were from 28%~95%with an average of 66.96%.The stenosis included:①Anastomotic stenosis;②Flex of renal artery;③Segmental stenosis of renal artery;④Thrombosis of Internal iliac artery.21 of 24 cases received interventional therapy,1 case was received the resection of the transplanted kidney because of thrombosis,2 cases refused any therapy.17 of 21 cases(73.9%)showed a stable decrease in serum creatinine value within 1 to 3 weeks,and the mean blood creatinine value decreased from 269.6μmol/L before interventional therapy to 190.1μmol/L,with a decrease of 29.5%.Conclusion Arterial stenosis is a common complication in recipients with renal allograft dysfunction and should be emphasized and screened routinely.Interventional therapy is the preferred treatment method for arterial stenosis,early detection and treatment could achieve certain clinical effects.

关 键 词：移植肾功能不全 肾动脉狭窄 肾移植 

分 类 号：R54[医药卫生—心血管疾病]