糖尿病患者中肾动脉狭窄的患病率。

The prevalence of renal artery stenosis among patients with diabetes mellitus.

机构信息

Department of General Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

出版信息

Eur J Intern Med. 2012 Oct;23(7):639-42. doi: 10.1016/j.ejim.2012.06.003. Epub 2012 Jun 23.

DOI:10.1016/j.ejim.2012.06.003

PMID:22939809

Abstract

BACKGROUND

Patients with diabetes mellitus (DM) have a high prevalence of atherosclerotic vascular lesions. It is therefore reasonable to assume that also the rate of renal artery stenosis (RAS) is higher. The presence of a RAS can have implications for the treatment of patients with diabetes mellitus and hypertension and renal impairment. Therefore it is important to be informed about the chance that a RAS is present among such patients.

METHODS

We prospectively studied the prevalence of atherosclerotic renal artery stenosis (RAS) among patients with diabetes mellitus. Patients were included if they were diagnosed with DM and hypertension with or without impairment of renal function. If causes of renal disease other than DM or hypertension were more probable on the basis of biochemical data, then such patients were excluded. A magnetic resonance angiography (MRA) of the renal arteries was made in 54 included successive patients.

PATIENT CHARACTERISTICS

mean age 59 ± 8.5 years (range 35 to 80). Eight patients had DM 1 and 46 DM 2. Mean BMI was 31.4 ± 5.6 kg/m(2). A RAS was present in 18 of the 54 (33%) patients, 3 patients had bilateral stenoses. Factors related to the presence of RAS were diastolic blood pressure, glomerular filtration rate and dyslipidaemia.

CONCLUSION

In this group of diabetic patients with hypertension and or renal impairment the prevalence of RAS was 33%.

摘要

背景

糖尿病（DM）患者常伴有动脉粥样硬化性血管病变。因此，我们有理由认为，肾动脉狭窄（RAS）的发生率也较高。RAS 的存在可能会影响糖尿病和高血压合并肾功能损害患者的治疗。因此，了解此类患者存在 RAS 的几率非常重要。

方法

我们前瞻性地研究了糖尿病患者中动脉粥样硬化性肾动脉狭窄（RAS）的患病率。如果患者被诊断为 DM 和高血压，无论是否伴有肾功能损害，均纳入研究。如果基于生化数据，患者的肾脏疾病更可能是由 DM 或高血压以外的原因引起，则将其排除在外。对 54 例连续入选的患者进行了磁共振血管造影（MRA）检查。

患者特征

平均年龄 59 ± 8.5 岁（范围 35 至 80 岁）。8 例患者为 1 型糖尿病，46 例为 2 型糖尿病。平均 BMI 为 31.4 ± 5.6 kg/m2。54 例患者中有 18 例（33%）存在 RAS，其中 3 例为双侧狭窄。与 RAS 存在相关的因素包括舒张压、肾小球滤过率和血脂异常。