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支架重建血运治疗肾动脉狭窄初步结果 被引量:11

Preliminary results of stenting revascularization as treatment for renal artery stenosis
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摘要 目的 评估支架重建血运治疗肾动脉狭窄的安全性与近期疗效。方法  30例肾动脉狭窄的患者因严重高血压或伴有肾功能不全而进行了肾动脉支架置放术 (PTRAS) ,并随诊 3个月 ,观察手术对患者血压、肾功能的影响。结果  30例患者中 ,PTRAS成功 2 9例 (96 7% ) ;至 3个月随诊时 ,患者血压明显下降 (P <0 0 0 1) ,收缩压从 173 5mmHg(1mmHg =0 133kPa)降至 135 8mmHg,舒张压从 95 8mmHg降至 75 6mmHg,患者服用降压药物种类明显减少 (从平均 2 5种减至 1 5种 ,P <0 0 0 1) ;其中 5例 (16 7% )治愈 ,2 2例 (73 3% )改善 ,3例 (10 % )无效 ;血肌酐 2例 (6 7% )轻度下降 ,2 8例 (93 3% )无变化。 Objectives To evaluate the safety and short-term efficacy of stent revascularization as treatment for renal artery stenosis. Methods Percutaneous transluminal renal angioplasty with stent (PTRAS) was performed on 30 consecutive patients with severe renal artery stenosis for poorly controlled hypertension or preservation of renal function. They subsequently underwent 3 -month clinical follow-up for the effect of the procedure on renal function, blood pressure control and the number of antihypertensive medications used. Results Angiographic success was obtained in 29 (96.7%) of the 30 patients after PTRAS. 3 months after the procedure systolic and diastolic blood pressures significantly decreased (from 173.5 to 135.8 mm Hg and from 95.8 to 75.6 mm Hg, respectively; P<0.001) and less antihypertensive medications were taken (from 2.5 to 1.5). Blood pressure in 5 (16.7%) of the 30 patients became normal without taking any antihypertensive medication and blood pressure control was more facile in 22 (73.3%) of the patients. However, there was no improvement in 3 (10.0%) of the patients. Creatinine slightly decreased in 2 (6.7%) of the 30 patients and remained stable in 28 (93.3%) of the 30 patients. There was no statistical significance in this respect. Conclusions Renal artery stent revascularization has a short-term beneficial effect on blood pressure control and a nondeleterious effect on renal function. The long-term efficacy should be investigated. The procedure is safe in usual.
机构地区 中国医学科学院
出处 《中华内科杂志》 CAS CSCD 北大核心 2002年第2期82-85,共4页 Chinese Journal of Internal Medicine
关键词 肾动脉梗阻 支架 高血压 肾功能衰竭 肾动脉狭窄 PTRAS Renal artery obstruction Stent Hypertension Kidney failure
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同被引文献132

  • 1蒋雄京,吴海英,明广华,王蕾礼,郑德裕,刘国仗,惠汝太,刘力生.支架置入重建血运治疗肾动脉狭窄中期临床结果[J].中华心血管病杂志,2005,33(3):224-227. 被引量:40
  • 2蒋雄京,吴海英,张慧敏,明广华,郑德裕,刘国仗,惠汝太,刘力生.肾动脉支架置入对缺血性肾病患者肾功能的影响[J].中华医学杂志,2005,85(29):2046-2049. 被引量:20
  • 3杨建勇,Thomas Roeren,Goetz M Richter,Goetz W Kaufmann.肾动脉内支架成形术的临床应用[J].中华放射学杂志,1996,30(5):306-311. 被引量:8
  • 4蒋雄京,吴海英,张慧敏,何作祥,郑德裕,刘国仗,惠汝太,刘力生.经皮肾动脉支架术治疗肾血管性高血压的临床结果[J].中国循环杂志,2006,21(2):89-92. 被引量:23
  • 5赵佳慧,马媛,程庆砾,张晓英,叶平.老年人动脉粥样硬化性肾动脉狭窄支架置人术治疗的疗效[J].中华老年医学杂志,2007,26(7):501-503. 被引量:1
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  • 7Plouin PF, Chatellier G, Darne B, et al. Blood pressure outcome of angioplasty in atheroselerotie renal artery stenosis: a randomized trial, t~ssai Multiccntrique Medicaments vs Angiopastie (EMMA) Study Group Hypertension, 1998, 31: 823-829.
  • 8Webster J, Marshall F, Abdalla M, et al. Randomised comparison of percutaneous anglo plasty vs continued medical therapy for hypertensive patients with atheromatous renal artery stenosis. J Hum Hypertens, 1998, 12: 329-335.
  • 9van Jaarsveld BC, Krijnen P, Pieterman H, et al. The effect of balloon angioplasty on hypertension in atherosclerotic renal-artery stenosis. Dutch Renal Artery Steosis Interrention Cooperative Study Group. N Engl J Med, 2000, 342: 1007-1014.
  • 10Bates MC,Campbell JE, Stone PA, et al. Factors affecting long-term survival following renal artery stenting. Catheter Cardiovasc Interv, 2007, 69: 1037-1043.

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