3D打印支架治疗胡桃夹综合征合并IgA肾病的疗效观察  

Efficacy of 3D printed extravascular stent in the treatment of nutcracker syndrome complicated with IgA nephropathy

作　　者：何大立 张波 严奉奇 崔栋 焦勇 HE Dali;ZHANG Bo;YAN Fengqi;CUI Dong;JIAO Yong(Department of Urology,Tangdu Hospital,Air Force Military Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学唐都医院泌尿外科,陕西西安710038

出　　处：《现代泌尿外科杂志》2022年第12期999-1003,共5页Journal of Modern Urology

基　　金：国家自然科学基金项目(No.82002686)。

摘　　要：目的观察3D打印血管外支架治疗胡桃夹综合征合并IgA肾病的疗效。方法回顾性分析2017年5月—2021年9月在空军军医大学唐都医院接受左肾静脉3D打印血管外支架植入术的19例胡桃夹综合征合并IgA肾病患者的资料,通过配对样本的统计学方法,分别对照术前、术后的影像学与临床检验结果,分析比较胡桃夹综合征合并不同Lee氏分级IgA肾病的治疗情况。结果随访数据显示19例患者术后至最新随访或随访结束影像学结果均呈现稳定。其中Lee氏分级Ⅱ级以下的16例患者肉眼血尿与蛋白尿症状均明显改善;此外,Lee氏分级Ⅲ级的3例患者虽然尿红细胞定量、24 h尿蛋白定量较术前也明显好转,但依然出现明显的肉眼血尿与蛋白尿,故需实施肾内科干预。结论3D打印血管外支架治疗胡桃夹综合征合并IgA肾病安全、有效,不同的Lee氏分级或可引导制定更加个性化的治疗方案。Objective To observe the efficacy of 3D printed extravascular stent in the treatment of nutcracker syndrome(NCS)complicated with IgA nephropathy(IgAN).Methods Clinical data of 19 NCS cases complicated with IgAN treated with left renal vein 3D printed extravascular stent implantation in our hospital during May.2017 and Sep.2021 were retrospectively analyzed.With paired samples,the preoperative and postoperative imaging and clinical test results were compared to analyze the efficacy in the trentment of NCS with different Lee's pathological grades of IgAN.Results The imaging results of all 19 patients were stable until the latest or the end of follow-up.The gross hematuria and proteinuria symptoms of 16 patients with Lee's pathological grade belowⅡwere significantly improved.In the 3 patients of Lee's pathological gradeⅢ,although the urine red blood cell quantification and 24-hour urine protein quantification were significantly improved,there were still obvious gross hematuria and proteinuria,so nephrology intervention had to be started.Conclusion 3D printed extravascular stent is safe and effective in the treatment of NCS complicated with IgAN,and Lee's pathological grade may guide the formulation of more personalized treatment plans.

关 键 词：胡桃夹综合征 3D打印血管外支架 IGA肾病 蛋白尿 血尿 

分 类 号：Q813.1[生物学—生物工程] R699[医药卫生—泌尿科学]