肾动脉支架置入术治疗老年高血压合并肾动脉狭窄患者的疗效观察  

Therapeutic effect of renal artery stenting in elderly hypertension patients with renal artery stenosis

作　　者：王悦喜[1] 范小娇 阿荣[1] 张迎军[1] 李鹏[1] 王海旭[1] 刘晓宇[1] Wang Yuexi;Fan Xiaojiao;A Rong;Zhang Yingjun;Li Peng;Wang Haixu;Liu Xiaoyu(Department of Cardiology,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,Inner Mongolia Autonomous Region,China)

机构地区：[1]内蒙古医科大学附属医院心内科,呼和浩特010050 [2]呼和浩特市妇幼保健医院医技科

出　　处：《中华老年心脑血管病杂志》2022年第5期495-498,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的 探讨老年高血压合并肾动脉狭窄患者支架置入术的疗效。方法 选择2011年1月~2016年1月在内蒙古医科大学附属医院心内科住院的老年高血压合并肾动脉重度狭窄患者84例,根据是否行经皮肾动脉支架置入术分为支架组34例和药物组50例,分别接受支架置入术和单纯降压药物治疗。采用肾动脉彩色多普勒超声和肾动脉CT造影检测肾动脉狭窄率。随访5年,观察患者血压控制效果及肾动脉狭窄进展情况。结果 支架组治疗后肾动脉残余狭窄率明显低于药物组,差异有统计学意义[(23.1±2.6)%vs(75.2±4.5)%,P<0.01]。随访5年,支架组全因病死率明显低于药物组(8.8%vs 12.0%,P<0.05),在存活患者中,支架组脑血管病事件发生率明显低于药物组(6.5%vs 15.9%,P=0.043);药物组用药种类、收缩压、舒张压、肾动脉狭窄率、肌酐及新发肾动脉狭窄比例明显高于支架组,差异有统计学意义(P<0.05,P<0.01)。结论 老年高血压合并肾动脉狭窄患者支架置入对预后有积极意义。Objective To study the therapeutic effect of renal artery stenting in elderly hypertension patients with renal artery stenosis.Methods Eighty-four elderly hypertension patients with renal artery stenosis admitted to our hospital from January 2011 to January 2016 were divided into renal artery stenting group(n=34) and medication group(n=50).The patients in renal artery stenting group underwent renal artery stening while those in medication group were treated with antihypertensive drugs.The renal artery stenosis in elderly hypertension patients was detected by color Doppler ultrasonography and CT angiography respectively.The patients were followed up for 5 years, during which their blood pressure control and renal artery stenosis progression were recorded.Results The rate of residual renal artery stenosis was significantly lower and the all-cause death rate was significantly lower in renal artery stenting group than in medication group(23.1%±2.6% vs 75.2%±4.5%,P<0.01;8.8% vs 12.0%,P<0.05).The incidence of cerebrovascular events was significantly lower while the types of drugs used in treatment of the patients were significantly more, the SBP,DBP,ratio of renal artery stenosis, ratio of new onset renal artery stenosis, and serum creatinine level were significantly higher in medication group than in renal artery stenting group(P<0.05,P<0.01).Conclusion Renal artery stenting can effectively improve the outcomes in elderly hypertension patients with renal artery stenosis.

关 键 词：肾动脉梗阻 支架 高血压 动脉粥样硬化 

分 类 号：R654.4[医药卫生—外科学] R544.1[医药卫生—临床医学]