Anfelter Peter, Granerus Göran, Stenström Hugo, Eriksson Per, Nyström Fredrik H
Department of Medicine and Care, Faculty of Health Sciences, University of Linkoping, Linköping, Sweden.
Blood Press. 2005;14(6):359-65. doi: 10.1080/08037050500339275.
The clinical effects of percutaneous transluminal renal artery angioplasty (PTRA) in patients with renal vascular stenosis and hypertension is controversial.
We consecutively recruited all 23 patients referred for evaluation of renovascular hypertension that eventually underwent unilateral PTRA, to be investigated with captopril MAG3 renography (CR), both before and after the endovascular procedure. Data were evaluated on an intention-to-treat basis.
We found that the relative MAG3 clearance of the stenotic kidney increased (from 29.9+/-14% to 35.1+/-14%, p=0.01) and that the creatinine levels fell following the intervention (from 110+/-19 to 99+/-17 micromol/l, p=0.0003). Blood pressure levels were also lowered (from 173+/-32/93+/-17 to 158+/-31/86+/-15 mmHg, p<0.006) while the mean number of anti-hypertensive drugs was unchanged following PTRA (2.9+/-1.4 before and 2.8+/-1.3 drugs after the intervention, respectively, p=0.6).
This prospective trial showed statistically significant improvements of individual kidney function as measured by CR and blood pressure in subjects with suspected renovascular hypertension treated with PTRA. Although the endovascular procedure was found to be safe, the magnitude of the absolute improvements was rather modest.
经皮腔内肾动脉血管成形术（PTRA）对肾血管狭窄和高血压患者的临床疗效存在争议。
我们连续招募了所有23例因肾血管性高血压接受评估并最终接受单侧PTRA的患者，在血管内手术前后均采用卡托普利巯基乙酰三甘氨酸肾图（CR）进行检查。数据按意向性分析原则进行评估。
我们发现，狭窄肾脏的相对MAG3清除率增加（从29.9±14%增至35.1±14%，p = 0.01），干预后肌酐水平下降（从110±19降至99±17微摩尔/升，p = 0.0003）。血压水平也有所降低（从173±32/93±17降至158±31/86±15毫米汞柱，p < 0.006），而PTRA后抗高血压药物的平均数量未变（干预前为2.9±1.4种，干预后为2.8±1.3种，p = 0.6）。
这项前瞻性试验表明，对于接受PTRA治疗的疑似肾血管性高血压患者，通过CR测量的单个肾功能和血压在统计学上有显著改善。尽管发现血管内手术是安全的，但绝对改善的幅度相当有限。
