Armanini D, Fallo F, Opocher G, Scaroni C, Mantero F
G Ital Cardiol. 1981;11(9):1276-82.
We have studied a group of 47 patients with unilateral or bilateral renal artery stenosis; 27 of them have been operated, while 20 have been subjected to medical treatment. Among the surgically treated patients, 18 out of the 22 cases with an unilateral stenosis had satisfactory results and didn't assume any treatment after surgical cure. All the 5 cases of bilateral stenosis presented a regular blood pressure after surgery. Nine among the 12 patients affected by unilateral stenosis and 3 among the 8 patients presenting bilateral forms who received medical treatment had successful results with the conventional therapy. The parameters that seems give a better prognostic indication for the surgical cure are either significant renal veins renin ratios (Ra/Rc and Rc/P), either high peripheral PRA values combined with a renal artery stenosis greater than or equal to 70%, in all the cases without evident damages in the opposite kidney, even if the renin ratios are not significant. The results of the medical treatment may be predicted from the entity of the renal stenosis. Failures are more likely to occur in the bilateral forms. In these cases the most satisfactory results can be obtained using minoxidil or the inhibitor of the converting enzyme of angiotensin I.
我们研究了一组47例单侧或双侧肾动脉狭窄患者；其中27例接受了手术治疗，20例接受了药物治疗。在接受手术治疗的患者中，22例单侧狭窄患者中有18例术后效果满意，术后治愈后无需任何治疗。所有5例双侧狭窄患者术后血压均正常。接受药物治疗的12例单侧狭窄患者中有9例、8例双侧狭窄患者中有3例采用传统治疗取得了成功。对于手术治愈似乎能给出更好预后指标的参数，要么是显著的肾静脉肾素比值（Ra/Rc和Rc/P），要么是外周PRA值高且合并肾动脉狭窄大于或等于70%，在所有对侧肾脏无明显损害的情况下，即使肾素比值不显著。药物治疗的结果可根据肾狭窄的程度来预测。双侧狭窄形式更容易出现治疗失败。在这些情况下，使用米诺地尔或血管紧张素I转换酶抑制剂可获得最满意的结果。
