Kennedy David J, Burket Mark W, Khuder Sadik A, Shapiro Joseph I, Topp Robert V, Cooper Christopher J
Department of Medicine, University of Toledo College of Medicine, Toledo, OH 43614-2598, USA.
Biol Res Nurs. 2006 Oct;8(2):129-37. doi: 10.1177/1099800406291459.
Although treatment of renal artery stenosis (RAS) with stents has been shown to improve blood pressure (BP) and renal function in some patients, little is known about the effect on health-related quality of life. A composite quality of life survey was administered in a cross-sectional cohort fashion to 149 patients presenting with angiographically and hemodynamically confirmed RAS either before (baseline, n = 37) or after (follow-up, n = 112) stent revascularization. BP, renal function, and antihypertensive medication use were also assessed. Systolic BP was lower in the revascularized patients (166 +/- 23 vs. 153 +/- 26, p < .01). The Short Form-36 Physical Component Summary (PCS) scores were higher (better) in revascularized patients (37 +/- 9 vs. 31 +/- 9, p < .01), whereas Mental Component Summary scores were equivalent (49 +/- 13 vs. 51 +/- 11, p = ns). Sleep dysfunction scores were lower (better) in the revascularized patients (32 +/- 26 vs. 48 +/- 32, p < .001), whereas self-reported appetite was higher (better; 62% +/- 29% vs. 73% +/- 27%,p < .05). After matching for age and gender, Short Form-36 PCS remained higher in the revascularized cohort (37 +/- 8 vs. 32 +/- 8, p < .05). Importantly, in multivariate analysis, revascularization was the most significant determinant of a higher PCS score (r2 = .07, beta = 5.21, p < .01). The current data suggest that renal artery stenting may improve health-related quality of life in patients with renovascular disease.
尽管已证明用支架治疗肾动脉狭窄（RAS）可使部分患者的血压（BP）和肾功能得到改善，但对于其对健康相关生活质量的影响却知之甚少。采用横断面队列研究的方式，对149例经血管造影和血流动力学证实为RAS的患者进行了综合生活质量调查，这些患者在支架血管重建术前（基线，n = 37）或术后（随访，n = 112）接受调查。同时还评估了血压、肾功能和抗高血压药物的使用情况。血管重建术后患者的收缩压较低（166±23 vs. 153±26，p <.01）。血管重建术后患者的简明健康状况调查量表身体成分总结（PCS）得分较高（较好）（37±9 vs. 31±9，p <.01），而精神成分总结得分相当（49±13 vs. 51±11，p =无统计学意义）。血管重建术后患者的睡眠功能障碍得分较低（较好）（32±26 vs. 48±32，p <.001），而自我报告的食欲较高（较好；62%±29% vs. 73%±27%，p <.05）。在按年龄和性别匹配后，血管重建队列中的简明健康状况调查量表PCS得分仍然较高（37±8 vs. 32±8，p <.05）。重要的是，在多变量分析中，血管重建是PCS得分较高的最显著决定因素（r2 =.07，β = 5.21，p <.01）。目前的数据表明，肾动脉支架置入术可能会改善肾血管疾病患者的健康相关生活质量。
