Martinez-Amenós A, Rama H, Sarrias X, Galcerán J, Alsina J, Montanyá X
Servei de Nefrologia, Hospital de Bellvitge Princeps d'Espanya, Barcelona, Spain.
J Hum Hypertens. 1991 Apr;5(2):97-100.
In this study we report our experience in 74 patients with hypertension and renal artery stenosis (42 with atherosclerotic stenosis, 32 with fibromuscular dysplasia) who were followed-up for a mean observation period of 21.7 months after percutaneous transluminal angioplasty (PTA). Stenosis was unilateral in 45 cases, bilateral in 16 and located in the renal artery of a solitary functioning kidney in 13 cases. Ostial involvement was observed in 26 cases. A total of 24 patients showed impaired renal function before PTA. Overall results for BP control were 8 cures (13%), 29 improvements (48%) and 24 (39%) who remained unchanged. Five of the 24 patients (21%) with impaired renal function showed improvement with a decrease in serum creatinine levels of more than 30%. Complications of PTA were rare, being limited to two haematomas at the puncture site which resolved spontaneously. These results emphasize that PTA, an easily repeatable procedure of relatively low risk, short hospital stay and low cost, is a first choice technique in the management of renovascular hypertension.
在本研究中，我们报告了74例高血压合并肾动脉狭窄患者（42例为动脉粥样硬化性狭窄，32例为纤维肌性发育异常）的治疗经验，这些患者在接受经皮腔内血管成形术（PTA）后平均随访观察21.7个月。45例患者为单侧狭窄，16例为双侧狭窄，13例狭窄位于孤立功能肾的肾动脉。26例患者可见开口处受累。共有24例患者在PTA前肾功能受损。血压控制的总体结果为8例治愈（13%），29例改善（48%），24例（39%）无变化。24例肾功能受损患者中有5例（21%）出现改善，血清肌酐水平下降超过30%。PTA的并发症很少见，仅限于穿刺部位的两处血肿，均自行消退。这些结果强调，PTA是一种易于重复、风险相对较低、住院时间短且成本低的手术，是治疗肾血管性高血压的首选技术。
