摘要
目的评价99mTc-DAPA肾动态显像对动脉粥样硬化性肾动脉狭窄支架植入术疗效的预测价值。方法对45例动脉粥样硬化性肾动脉狭窄患者,共54条经皮肾腔内血管成形术及支架置入术(percutaneous transluminal renal angioplasty and stent,PTRAS),分别于术前2周内和术后6个月进行99mTc-DAPA肾动态显像,利用Gates法测定患侧肾小球滤过率(glomerular filtration rate,GFR),血清肌酐(serum creatinine,SCr)、血压。根据术前GFR测定结果,将患肾功能分为GFRⅠ级(GFR≥30 ml/min)、GFRⅡ级(15 ml/min≤GFR<30 ml/min)和GFRⅢ级(GFR<15 ml/min)。分析患者术前术后患侧肾(分肾)GFR、肾血流灌注、术前与术后血压、服用降压药种类和剂量的变化、血清肌酐变化。结果术后GFR改善较为明显,尤其GFRⅠ级、GFRⅡ级,肾血流灌注增加,明显高于GFRⅢ级,差异具有统计学意义(P<0.05)。GFRⅠ级、GFRⅡ级患者术后控制血压有效例数高于GFRⅢ级患者,差异具有统计学意义(P<0.05)。术后收缩压由(165±18)mmHg降至(138±12)mmHg,舒张压由(100±12)mmHg降至(88±8)mmHg,降压药种类、剂量较术前减少。与术前比较,差异具有统计学意义(P<0.05);手术前后患者血清肌酐水平差异,无统计学意义(P>0.05)。单侧治疗效果好于双侧,差异具有统计学意义(P<0.05)。结论99mTc-DAPA肾动态显像术前术后的检查结果GFR可用于客观评价动脉粥样硬化性肾动脉狭窄支架植入术的疗效,对动脉粥样硬化性肾动脉狭窄(atherosclerotic renal artery stenosis,ARAS)的PTRAS疗效有预测价值。
Objective To evaluate the predictive value of 99mTc-DAPA renal dynamic imaging for stent placement for atherosclerotic renal artery stenosis.Methods For 45 patients with atherosclerotic renal artery stenosis,a total of 54 renal artery underwent stent placement(percutaneous transluminal renal angioplasty and stent,PTRAS),99mTc-dapa renal dynamic imaging was performed within 2 weeks before surgery and 6 months after operation respectively.The glomerular filtration rate of the affected side was measured by Gates method(glomerular filtration rate,GFR),creatinine,blood pressure.According to the results of preoperative GFR determination of renal function can be divided into GFR levelⅠ(GFR≥30 ml/min),GFR levelⅡ(15 ml/min≤GFR<30 ml/min)and GFR levelⅢ(GFR<15 ml/min).GFR,renal perfusion and function of the affected kidney before and after operation were analyzed.Preoperative and postoperative changes in blood pressure,types and doses of antihypertensive medicines,and serum creatinine serum creatinine changes were analyzed.Results Postoperative GFR was evidently improve,especially in GFRⅠ,GFRⅡ,renal perfusion increased higher than that in the GFRⅢwith statistically significant difference(P<0.05).The number of patients with GFRⅠand GFRⅡpostoperative effective blood pressure control was higher than that of patients with GFRⅢwith statistically significant differences(P>0.05).Postoperative systolic blood pressure decreased from(165±18)mmHg to(138±12)mmHg,and diastolic blood pressure decreased from(100±12)mmHg to(88±8)mmHg.The dose of antihypertensive medicines was lower than that before operation with statistically significant differences(P<0.05).There was no significant difference in serum creatinine before and after operation(P>0.05).Unilateral treatment was better than bilateral treatment with statistically significant differences(P<0.05).Conclusions 99mTc-DAPA dynamic renal imaging can be used to evaluate the efficacy of stent implantation for atherosclerotic renal artery stenosis.
作者
段磊
顾俊鹏
任伟新
纪卫政
张海潇
朱帝文
曹耿飞
鲍应军
阿斯哈尔·哈斯木
Duan Lei;Gu Junpeng;Ren Weixin;Ji Weizheng;Zhang Haixiao;Zhu Diwen;Cao Gengfei;Bao Yingjun;Ashar Hsmer(Department of Interventional Radiology,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Urumqi 830011,China)
出处
《中华介入放射学电子杂志》
2020年第2期175-179,共5页
Chinese Journal of Interventional Radiology：electronic edition
作者简介
通信作者:任伟新,Email:cjr.renweixin@vip.163.com。
