Louie J, Isaacson J A, Zierler R E, Bergelin R O, Strandness D E
Department of Surgery, University of Washington School of Medicine, Seattle 98195.
Am J Hypertens. 1994 May;7(5):436-9. doi: 10.1093/ajh/7.5.436.
Atherosclerosis is the most common cause of renovascular hypertension secondary to hemodynamically significant stenoses (> 60% diameter reduction). To assess the prevalence of atherosclerosis in the peripheral arteries and carotid bifurcation, we prospectively studied 60 patients who had renal artery stenosis documented by ultrasonic duplex scanning. Disease of the peripheral arterial circulation was assessed by the measurement of the ankle/brachial systolic pressure ratio. To evaluate the extracranial carotid artery, ultrasonic duplex scanning was employed. The prevalence of a 50-100% diameter reducing stenosis in the carotid artery was 46% in patients with a > 60% diameter reducing renal artery stenosis. The prevalence of severe peripheral arterial disease was 73% in those patients with a high grade renal artery lesion. The prevalence of severe disease in the peripheral and carotid arteries was less (50% and 25%, respectively) in patients with renal artery lesions that reduced the diameter of the renal artery less than 60%. The high prevalence of associated lesions in the carotid and peripheral circulation in patients with renovascular disease secondary to atherosclerosis should prompt investigation of these major arteries when renal artery disease is detected. Disease of the carotid and peripheral arteries is a common cause of morbidity and should be treated according to accepted guidelines.
动脉粥样硬化是血流动力学显著狭窄（直径减少>60%）继发的肾血管性高血压最常见的病因。为评估外周动脉和颈动脉分叉处动脉粥样硬化的患病率，我们前瞻性地研究了60例经超声双功扫描记录有肾动脉狭窄的患者。通过测量踝/臂收缩压比值评估外周动脉循环疾病。为评估颅外颈动脉，采用了超声双功扫描。在肾动脉直径减少>60%的患者中，颈动脉直径减少50 - 100%的狭窄患病率为46%。在那些有高级别肾动脉病变的患者中，严重外周动脉疾病的患病率为73%。在肾动脉病变使肾动脉直径减少小于60%的患者中，外周和颈动脉严重疾病的患病率较低（分别为50%和25%）。继发于动脉粥样硬化的肾血管疾病患者中，颈动脉和外周循环相关病变的高患病率应促使在检测到肾动脉疾病时对这些主要动脉进行检查。颈动脉和外周动脉疾病是常见的发病原因，应根据公认的指南进行治疗。
