Peco-Antić Amira, Stajić Nataša, Krstić Zoran, Bogdanović Radovan, Miloševski-Lomić Gordana, Đukić Milan, Paripović Dušan
Medical School of University of Belgrade, Belgrade, Serbia.
Nephrology Department, University Children's Hospital, Belgrade, Serbia.
Acta Paediatr. 2016 Jan;105(1):e35-41. doi: 10.1111/apa.13229. Epub 2015 Nov 4.
This studied reviewed renovascular hypertension (RVH) due to renal artery stenosis (RAS) in two Serbian paediatric centres from 2001 to 2013.
The patients' demographic data, underlying syndromes, blood pressure (BP), antihypertensive treatments and outcomes were reviewed.
The incidence of RVH was 1.9 per million children per year during the study period, and there were 25 patients with RAS, aged 10.4 ± 5.2 years. At presentation, their mean blood pressure (BP) standard deviation scores were 6.9 ± 3.4 systolic and 5.2 ± 2.6 diastolic. BP loads on 24-hour ambulatory BP were 88 ± 14% systolic and 80 ± 29% diastolic. We found that 72% had fibromuscular dysplasia and 28% had underlying syndromes. RAS was unilateral in 64% and bilateral in 28%, and 8% had RAS of a single kidney. Antihypertensive treatment included antihypertensive drugs (100%), percutaneous transluminal angioplasty (92%), renal auto-transplantation (16%), surgical revascularisation (12%) and nephrectomy (12%). After 4.4 ± 3.6 years of follow-up, high BP was cured in 40% of the patients and 39.4% of the kidneys and improved in 48% (75.7%), with BP decreases of 20.3 ± 3.7% systolic and 16.3 ± 6.2% diastolic.
Fibromuscular dysplasia was the most common cause of RVH in this study, and hypertension was cured or improved in 88% of the patients.
本研究回顾了2001年至2013年期间塞尔维亚两个儿科中心因肾动脉狭窄（RAS）导致的肾血管性高血压（RVH）情况。
回顾了患者的人口统计学数据、基础综合征、血压（BP）、降压治疗及预后情况。
研究期间RVH的发病率为每年每百万儿童中有1.9例，共有25例RAS患者，年龄为10.4±5.2岁。就诊时，他们的平均血压（BP）标准差评分收缩压为6.9±3.4，舒张压为5.2±2.6。24小时动态血压监测的血压负荷收缩压为88±14%，舒张压为80±29%。我们发现72%的患者患有纤维肌性发育异常，28%有基础综合征。RAS单侧的占64%，双侧的占28%，8%为单肾的RAS。降压治疗包括使用降压药物（100%）、经皮腔内血管成形术（92%）、自体肾移植（16%）、外科血管重建术（12%）和肾切除术（12%）。经过4.4±3.6年的随访，40%的患者高血压治愈，39.4%的肾脏情况改善，48%（75.7%）的患者血压改善，收缩压下降20.3±3.7%，舒张压下降16.3±6.2%。
在本研究中，纤维肌性发育异常是RVH最常见的原因，88%的患者高血压得到治愈或改善。
