Chen Yonghui, Pan Hongrui, Luo Guangze, Li Peng, Dai Xiangchen
Vascular Surgery Department, Tianjin Medical University General Hospital, Tianjin, China.
J Int Med Res. 2021 Jan;49(1):300060520983585. doi: 10.1177/0300060520983585.
For patients with atherosclerotic renal artery stenosis (ARAS), the role of percutaneous transluminal renal angioplasty (PTRA) remains inconclusive. This study aimed to comparatively evaluate the benefits of best medical therapy (BMT) plus PTRA and BMT alone in treating ARAS.
We performed a systematic review and meta-analysis, and searched for all randomized, controlled trials that reported patients with ARAS. The effectiveness and safety in the BMT plus PTRA and BMT alone groups were estimated, taking into account hypertension, stroke, renal events, cardiac events, and mortality.
Nine randomized, controlled trials involving 2309 patients were included. In the BMT plus PTRA group, the incidence of refractory hypertension was significantly lower compared with that in the BMT alone group (odds ratio 0.09; 95% confidence interval 0.01, 0.70). However, there were no significant differences in the rates of stroke, renal events, cardiac events, cardiac mortality, and all-cause mortality between the two groups.
PTRA plus BMT improves blood pressure in patients with ARAS, but there is insufficient evidence for this therapy in improving stroke, renal events, cardiac events, and cardiac and all-cause mortality.
对于动脉粥样硬化性肾动脉狭窄（ARAS）患者，经皮腔内肾血管成形术（PTRA）的作用仍不明确。本研究旨在比较评估最佳药物治疗（BMT）联合PTRA与单纯BMT治疗ARAS的益处。
我们进行了一项系统评价和荟萃分析，检索了所有报告ARAS患者的随机对照试验。在考虑高血压、中风、肾脏事件、心脏事件和死亡率的情况下，评估了BMT联合PTRA组和单纯BMT组的有效性和安全性。
纳入了9项涉及2309例患者的随机对照试验。与单纯BMT组相比，BMT联合PTRA组难治性高血压的发生率显著降低（优势比0.09；95%置信区间0.01, 0.70）。然而，两组之间的中风、肾脏事件、心脏事件、心源性死亡率和全因死亡率发生率没有显著差异。
PTRA联合BMT可改善ARAS患者的血压，但该疗法在改善中风、肾脏事件、心脏事件以及心源性和全因死亡率方面证据不足。
