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同时接受冠状动脉和肾动脉血管造影的高血压患者中动脉粥样硬化性肾动脉狭窄的患病率及预测因素;一项横断面研究。

Prevalence and predictors of atherosclerotic renal artery stenosis in hypertensive patients undergoing simultaneous coronary and renal artery angiography; a cross-sectional study.

作者信息

Payami Babak, Jafarizade Mehrian, Beladi Mousavi Seyed Seifollah, Sattari Shahab-Aldin, Nokhostin Forough

机构信息

Department of Cardiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

J Renal Inj Prev. 2016 Feb 18;5(1):34-8. doi: 10.15171/jrip.2016.08. eCollection 2016.

Abstract

INTRODUCTION

According to the non-specific presentation of atherosclerotic renal artery stenosis (ARAS), this disease is usually an under-diagnosed in clinical conditions.

OBJECTIVES

The aim of the presence study was to evaluate the prevalence of renal artery stenosis (RAS) and its related risk factors in hypertensive patients undergoing coronary angiography.

PATIENTS AND METHODS

In a cross-sectional study, between March 2009 and October 2010, all of hypertensive patients candidate for diagnostic cardiac catheterization, underwent nonselective renal angiography before completion of their coronary angiography procedure. A standardized questionnaire was used to collect demographics, cardiac history, indications for cardiac catheterization and angiographic data. The degree of ARAS was estimated visually by skilled cardiologist. Narrowing greater than 50% of the arterial lumen considered as arterial stenosis. Data was analyzed by SPSS version 19, and by chi-square test and logistic regression model.

RESULTS

In overall 274 patients with mean age of 60.75 ± 10.92 years 108 (39.4%) were male and 166 (60.61%) were female. The prevalence of ARAS calculated 18.2%. According to the present study, heart failure and smoking were predictors of ARAS. However, old age, gender, diabetes mellitus, hyperlipidemia and family history of cardiovascular disease were not clinical predictors of significant ARAS in hypertensive patients, candidate for coronary angiography.

CONCLUSION

According to present data, we suggest to consider renal artery angiography in combination with coronary artery angiography especially in hypertensive patients who are smoker or individuals who have heart failure.

摘要

引言

由于动脉粥样硬化性肾动脉狭窄(ARAS)的表现不具有特异性,该疾病在临床中常常诊断不足。

目的

本研究旨在评估接受冠状动脉造影的高血压患者中肾动脉狭窄(RAS)的患病率及其相关危险因素。

患者与方法

在一项横断面研究中,于2009年3月至2010年10月期间,所有拟行诊断性心导管检查的高血压患者在完成冠状动脉造影术前均接受了非选择性肾血管造影。使用标准化问卷收集人口统计学资料、心脏病史、心导管检查指征及血管造影数据。由经验丰富的心脏病专家通过视觉评估ARAS的程度。动脉管腔狭窄超过50%被视为动脉狭窄。数据采用SPSS 19版进行分析,并通过卡方检验和逻辑回归模型进行分析。

结果

总共274例患者,平均年龄为60.75±10.92岁,其中男性108例(39.4%),女性166例(60.61%)。ARAS的患病率为18.2%。根据本研究,心力衰竭和吸烟是ARAS的预测因素。然而,年龄、性别、糖尿病、高脂血症及心血管疾病家族史并非接受冠状动脉造影的高血压患者中显著ARAS的临床预测因素。

结论

根据目前的数据,我们建议尤其是在吸烟的高血压患者或患有心力衰竭的个体中,考虑将肾动脉造影与冠状动脉造影联合进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c066/4827384/309ddce5b086/jrip-5-34-g001.jpg

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