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经皮腔内肾血管成形术伴支架置入术治疗肾动脉粥样硬化性狭窄患者的血压控制和肾功能改善有效。

Percutaneous transluminal renal angioplasty with stent is effective for blood pressure control and renal function improvement in atherosclerotic renal artery stenosis patients.

机构信息

Department of Vascular Surgery, Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.

出版信息

Chin Med J (Engl). 2012 Apr;125(8):1363-8.

Abstract

BACKGROUND

Percutaneous transluminal renal angioplasty with stent is an effective procedure for atherosclerotic renal artery stenosis. However, the decision to perform this procedure has recently raised considerable debate. The aim of this study was to assess the effects of percutaneous transluminal renal angioplasty with stent in atherosclerotic renal artery stenosis patients, especially as it relates to blood pressure control and renal function improvement.

METHODS

A retrospective analysis was made of the clinical data from 125 atherosclerotic renal artery stenosis patients who underwent percutaneous transluminal renal angioplasty from July 2004 to June 2008 in the Department of Vascular Surgery of Beijing Chaoyang Hospital. We compared blood pressure, number of oral antihypertensive medications, and renal function changes pre and post-procedure at 24 months follow-up.

RESULTS

A total of 125 atherosclerotic renal artery stenosis patients underwent percutaneous transluminal renal angioplasty and 143 stents were placed. At 24 months follow-up, both systolic and diastolic blood pressure and the number of oral antihypertensive medications were significantly reduced (P < 0.05). Overall, the estimated glomerular filtration rate did not change significantly (P > 0.05); however, a significant increase in estimated glomerular filtration rate was observed in the subgroup of patients with a lower baseline estimated glomerular filtration rate and in the subgroup of patients with bilateral renal artery stenosis (P < 0.05).

CONCLUSION

Percutaneous transluminal renal angioplasty is a safe procedure for atherosclerotic renal artery stenosis patients, providing a significant improvement in blood pressure control and reduction in the number of oral antihypertensive medications.

摘要

背景

经皮腔内肾血管成形术伴支架置入术是治疗动脉粥样硬化性肾动脉狭窄的有效方法。然而,最近对该手术的适应证存在很大争议。本研究旨在评估经皮腔内肾血管成形术伴支架置入术在动脉粥样硬化性肾动脉狭窄患者中的疗效,特别是与血压控制和肾功能改善的关系。

方法

回顾性分析 2004 年 7 月至 2008 年 6 月北京朝阳医院血管外科收治的 125 例接受经皮腔内肾血管成形术的动脉粥样硬化性肾动脉狭窄患者的临床资料。比较患者术前及术后 24 个月的血压、口服降压药物种类和肾功能变化。

结果

共 125 例动脉粥样硬化性肾动脉狭窄患者接受经皮腔内肾血管成形术,共置入 143 枚支架。术后 24 个月,收缩压、舒张压和口服降压药物种类均明显减少(P<0.05)。总体估算肾小球滤过率无明显变化(P>0.05);但在基线估算肾小球滤过率较低的患者亚组和双侧肾动脉狭窄患者亚组中,估算肾小球滤过率有明显升高(P<0.05)。

结论

经皮腔内肾血管成形术治疗动脉粥样硬化性肾动脉狭窄安全有效,可显著改善血压控制,减少口服降压药物种类。

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