分侧肾小球滤过率评估动脉粥样硬化性单侧肾动脉狭窄经皮肾动脉支架植入术效果分析  

Application of ipsilateral glomerular filtration rate in evaluating the efficacy of percutaneous transluminal renal angioplasty with stent for unilateral atherosclerotic renal artery stenosis

作　　者：曾一梅[1] 许建忠[1] 陈歆[1] 初少莉[1] 李明春[1] ZENG Yimei;XU Jianzhong;CHEN Xin;CHU Shaoli;LI Mingchun(Department of Hypertension,Affiliated Ruijin Hospital,School of Medicine of Shanghai Jiao Tong University,Shanghai 201800,China)

机构地区：[1]上海交通大学医学院附属瑞金医院高血压科,201800

出　　处：《介入放射学杂志》2021年第10期1003-1005,共3页Journal of Interventional Radiology

摘　　要：目的评价分侧肾小球滤过率(GFR)评估动脉粥样硬化性单侧肾动脉狭窄经皮肾动脉支架植入术(PTRAS)效果的作用。方法选择2014年7月至2019年7月在上海瑞金医院接受PTRAS治疗的64例动脉粥样硬化所致肾动脉狭窄患者。术前、术后12个月检测患者肾功能,血压水平,99mTc-乙二胺四乙酸(EDTA)检测分侧GFR,比较术前、术后患者血压水平、服用降压药种类、肾小球滤过率估计值(e GFR)及分侧GFR等变化。结果 PTRAS术前患者患侧GFR显著低于健侧(P=0.002),术后12个月患侧GFR与健侧差异无统计学意义(P>0.05)。术后12个月,患者收缩压、舒张压与术前相比均显著下降(P<0.001,P=0.003),但降压药种类、e GFR较术前差异均无统计学意义(P>0.05),患侧GFR较术前显著改善(P=0.001)。结论 PTRAS可提高动脉粥样硬化性肾动脉狭窄患者患侧GFR,分侧GFR下降可作为行PTRAS术指征之一。Objective To discuss the application of ipsilateral glomerular filtration rate(GFR) in evaluating the efficacy of percutaneous transluminal renal angioplasty with stent(PTRAS) for unilateral atherosclerotic renal artery stenosis. Methods A total of 64 patients with renal artery stenosis caused by atherosclerosis, who received PTRAS treatment at Shanghai Ruijin Hospital of China between July 2014 and July 2019, were enrolled in this study. The preoperative and postoperative 12-month renal function and blood pressure were measured, and ipsilateral GFR testing with 99mTc-EDTA was also performed. The postoperative blood pressure, type of anti-hypertension drugs, estimated GFR(eGFR), and ipsilateral GFR were compared with the preoperative data. Results Before PTRAS, the GFR of the affected side was significantly lower than that of the healthy side(P=0.002). Twelve months after PTRAS, the difference in GFR between the affected side and healthy side was not statistically significant(P>0.05), both the systolic blood pressure and diastolic blood pressure were remarkably decreased when compared with preoperative data(P<0.001 and P=0.003, respectively)although the type of anti-hypertension drugs and e GFR value were not obviously different from preoperative ones(P>0.05), the postoperative GFR at the affected side was significantly improved when compared with its preoperative value(P=0.001). Conclusion In treating unilateral atherosclerotic renal artery stenosis, PTRAS can improve the GFR of the affected side kidney. Decreased GFR of the affected side kidney can be used as an indication for PTRAS treatment.(J Intervent Radiol, 2021, 30: 1003-1005)

关 键 词：动脉粥样硬化 肾动脉狭窄 经皮肾动脉支架植入术 分侧肾小球滤过率 

分 类 号：R692[医药卫生—泌尿科学]