Kumagai H, Suzuki H, Matsukawa S, Ryuzaki M, Saruta T
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Arch Intern Med. 1989 Sep;149(9):1973-6.
To establish an optimal approach for the patients with bilateral atherosclerotic renal artery stenosis, combined treatment involving percutaneous transluminal renal angioplasty and oral captopril was applied. Five patients were examined for effects of the combined treatment on blood pressure and renal function. After percutaneous transluminal renal angioplasty on one renal artery, the blood pressure (mean +/- SD) fell from 210/118 +/- 26/8 to 176/104 +/- 11/9 mm Hg without any deterioration of renal function. This reduced blood pressure was further lowered to 155/92 +/- 6/3 mm Hg by adding captopril therapy. This level of blood pressure has been maintained for an average of 37 months. Significant increases in serum creatinine concentration were not observed (124 +/- 27 vs 141 +/- 44 mumol/L), and renal size has been sustained. These results indicate that combined treatment with percutaneous transluminal renal angioplasty and captopril is effective in reducing the blood pressure and preserving renal function as an approach for the patients with bilateral atherosclerotic renal artery stenosis.
为确定双侧动脉粥样硬化性肾动脉狭窄患者的最佳治疗方法，采用了经皮腔内肾血管成形术联合口服卡托普利的综合治疗。对5例患者进行了综合治疗对血压和肾功能影响的检查。在对一侧肾动脉进行经皮腔内肾血管成形术后，血压（平均值±标准差）从210/118±26/8降至176/104±11/9 mmHg，肾功能无任何恶化。通过加用卡托普利治疗，血压进一步降至155/92±6/3 mmHg。该血压水平平均维持了37个月。未观察到血清肌酐浓度显著升高（124±27与141±44 μmol/L），肾脏大小保持稳定。这些结果表明，经皮腔内肾血管成形术联合卡托普利治疗作为双侧动脉粥样硬化性肾动脉狭窄患者的一种治疗方法，在降低血压和保护肾功能方面是有效的。
