Lamawansa M D, Bell R, Kumar A, House A K
Department of Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia.
Ann R Coll Surg Engl. 1995 Sep;77(5):337-41.
The aim of this study was to identify preoperative angiographic criteria which could be used to predict the response to renovascular reconstruction. A cohort of 49 patients who survived for more than 6 months after renovascular reconstruction was studied. All preoperative angiograms were reviewed independently and the renal size, degree of stenosis and the length of the lesion recorded. The response of blood pressure and renal function to surgery were correlated with the angiographic findings. We found that 58% of patients had long-term improvement in blood pressure control, though the response was significantly better where both kidneys were >12 cm in size (82%) compared with when both kidneys were < 12 cm (25%), P < 0.02. The degree of stenosis, while showing a trend towards a better blood pressure response with increasing stenosis, was not a statistically significant factor. None of the angiographic criteria examined could be used to predict the response in renal function. We have shown that the preoperative renal size is the only angiographic factor that may have some role in predicting the response of blood pressure to renovascular reconstruction.
本研究的目的是确定可用于预测肾血管重建反应的术前血管造影标准。对49例肾血管重建术后存活超过6个月的患者进行了研究。所有术前血管造影均由专人独立复查，并记录肾脏大小、狭窄程度和病变长度。血压和肾功能对手术的反应与血管造影结果相关。我们发现，58%的患者血压控制得到长期改善，不过，双肾大小均>12 cm的患者反应明显更好（82%），而双肾大小均<12 cm的患者反应则为25%，P<0.02。狭窄程度虽显示随着狭窄程度增加血压反应有改善趋势，但并非具有统计学意义的因素。所检查的血管造影标准均无法用于预测肾功能反应。我们已经表明，术前肾脏大小是唯一可能在预测血压对肾血管重建反应中起一定作用的血管造影因素。
