Gonthier R, Sabatier J C, Genin C, Toulon J, Laurent B, Veyret C, Gelet A, Tostain J, Barral X, Berthoux F C
Nephrologie. 1981;2(4):178-83.
We analyzed retrospectively 12 patients, aged from 63 to 73 years, with renovascular hypertension due to unilateral or bilateral atheromatous lesions (4 out of 12). Malignant or accelerated hypertension with multiple visceral involvement was frequent (8 out of 12). The proximal lesions (stenosis) of the renal arteries were rapidly progressive, leading to complete thrombosis in 8 cases. Five patients received medical treatment only, but 2 worsened their GFR and 2 had a poor blood pressure control. Of the 5 patients who underwent renal surgery 2 had nephrectomy, 2 had an aorto-renal bypass and 1 a bypass plus nephrectomy; 2 of them recovered a normal GFR, but 2 died in the post-operative period. Three patients had selective embolization of a renal artery, but only one was definitely improved. So far, the treatment of such cases still is very difficult.
我们回顾性分析了12例年龄在63至73岁之间、因单侧或双侧动脉粥样硬化病变(12例中有4例)导致肾血管性高血压的患者。恶性或急进性高血压伴多脏器受累较为常见(12例中有8例)。肾动脉近端病变(狭窄)进展迅速,8例导致完全血栓形成。5例仅接受药物治疗,但2例肾小球滤过率(GFR)恶化,2例血压控制不佳。在接受肾脏手术的5例患者中,2例行肾切除术,2例行主动脉 - 肾动脉搭桥术,1例行搭桥加肾切除术;其中2例恢复了正常的GFR,但2例在术后死亡。3例患者接受了肾动脉选择性栓塞术,但只有1例有明确改善。迄今为止,此类病例的治疗仍然非常困难。