Singer Gregory M, Setaro John F, Curtis Jeptha P, Remetz Michael S
Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520-8017, USA.
J Clin Hypertens (Greenwich). 2008 Nov;10(11):830-6. doi: 10.1111/j.1751-7176.2008.00030.x.
Distal embolic protection (DEP) may prevent embolization of atherosclerotic debris during renal artery stenting. The authors retrospectively identified 48 hypertensive patients with chronic kidney disease (CKD) who underwent renal artery stenting between 2002 and 2005 and compared stenting alone (n=17) to stenting/DEP (n=31). Blood pressure (BP) and estimated glomerular filtration rate (eGFR) (mL/min/1.73m(2)) at baseline at 6 and 12 months were compared. Overall, eGFR improved by 4.7 (P=.005) at 6 months and 3.8 (P=.003) at 12 months compared with baseline. Comparing stent to stent/DEP patients, eGFR improvement did not differ at 6 months (7.6 vs 2.9; P=.15) or at 12 months (4.4 vs 3.5; P=.74). Systolic BP reduction was similar between stent and stent/DEP patients at 6 months (-9 vs -14 mm Hg; P=.59) and at 12 months (-18 vs -16 mm Hg; P=.89). Renal artery stenting improved eGFR and systolic BP in patients with hypertension and CKD; however, DEP did not enhance these effects.
远端栓子保护（DEP）可能会预防肾动脉支架置入过程中动脉粥样硬化碎片的栓塞。作者回顾性地确定了48例在2002年至2005年期间接受肾动脉支架置入术的慢性肾脏病（CKD）高血压患者，并将单纯支架置入组（n = 17）与支架置入/DEP组（n = 31）进行比较。比较了基线时、6个月和12个月时的血压（BP）和估算肾小球滤过率（eGFR）（mL/min/1.73m²）。总体而言，与基线相比，eGFR在6个月时提高了4.7（P = 0.005），在12个月时提高了3.8（P = 0.003）。比较单纯支架置入组和支架置入/DEP组患者，6个月时（7.6对2.9；P = 0.15）和12个月时（4.4对3.5；P = 0.74）eGFR的改善没有差异。单纯支架置入组和支架置入/DEP组患者在6个月时收缩压降低情况相似（-9对-14 mmHg；P = 0.59），在12个月时也相似（-18对-16 mmHg；P = 0.89）。肾动脉支架置入术改善了高血压和CKD患者的eGFR和收缩压；然而，DEP并未增强这些效果。
