在因肾动脉造影而就诊的高血压患者中，间歇性跛行与严重肾动脉狭窄独立相关。

Intermittent claudication and severe renal artery stenosis are independently associated in hypertensive patients referred for renal arteriography.

作者信息

Macedo Thiago Andrade, Drager Luciano Ferreira, Pedrosa Rodrigo Pinto, Muela Henrique Cotchi Simbo, Costa-Hong Valeria, Kajita Luiz Junia, Bortolotto Luiz Aparecido

机构信息

Unidade de Hipertensão, Divisão de Cardiologia, Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR.

Laboratório de Hemodinâmica, Divisão de Cardiologia, Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR.

出版信息

Clinics (Sao Paulo). 2017 Jul;72(7):411-414. doi: 10.6061/clinics/2017(07)04.

DOI:10.6061/clinics/2017(07)04

PMID:28793000

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5525161/

Abstract

OBJECTIVE

: The purpose of this study was to evaluate the association between the presence of clinical symptoms of peripheral artery disease and severe renal artery stenosis in patients referred for renal angiography.

METHOD

: We included 82 patients with clinical suspicion of renovascular hypertension and performed an imaging investigation (renal Doppler ultrasound and/or renal scintigraphy) for possible renal artery stenosis. All patients underwent renal arteriography and were examined for peripheral artery disease based on the presence of intermittent claudication and ankle-brachial index test results. Severe renal artery stenosis was defined as a lesion causing 70% obstruction.

RESULTS

: Severe renal artery stenosis was present in 32 of 82 (39%) patients. Patients with severe renal artery stenosis were older (63±12 vs 56±12 years, p=0.006), had more intermittent claudication (55 vs 45%, p=0.027), and had a greater prevalence of an ankle-brachial index <0.9 (44% vs 20%, p=0.021) than patients without severe renal artery stenosis. Multivariate logistic regression analysis showed that the presence of intermittent claudication was independently associated with renal artery stenosis ≥70% (OR: 3.33; 95% CI 1.03-10.82, p=0.04), unlike the ankle-brachial index, which showed no association (OR: 1.44; 95% CI 0.37-5.66, p=0.60).

CONCLUSION

: Intermittent claudication is independently associated with severe renal artery stenosis (≥70%) in patients clinically suspected of having renovascular hypertension.

摘要

目的

本研究旨在评估因肾血管造影而就诊的患者外周动脉疾病临床症状的存在与严重肾动脉狭窄之间的关联。

方法

我们纳入了82例临床怀疑有肾血管性高血压的患者，并对可能的肾动脉狭窄进行了影像学检查（肾多普勒超声和/或肾闪烁显像）。所有患者均接受了肾动脉造影，并根据间歇性跛行的存在情况和踝臂指数测试结果对其外周动脉疾病进行了检查。严重肾动脉狭窄定义为导致70%阻塞的病变。

结果

82例患者中有32例（39%）存在严重肾动脉狭窄。与无严重肾动脉狭窄的患者相比，严重肾动脉狭窄患者年龄更大（63±12岁对56±12岁，p=0.006），间歇性跛行更多（55%对45%，p=0.027），踝臂指数<0.9的患病率更高（44%对20%，p=0.021）。多因素逻辑回归分析显示，间歇性跛行的存在与肾动脉狭窄≥70%独立相关（比值比：3.33；95%置信区间1.03 - 10.82，p=0.04），而踝臂指数则无关联（比值比：1.44；95%置信区间0.37 - 5.66，p=0.60）。