Scoble J E, Sweny P, Stansby G, Hamilton G
King's College Hospital, London, UK.
Postgrad Med J. 1993 Jun;69(812):461-5. doi: 10.1136/pgmj.69.812.461.
During a 6 year period 60 patients with atherosclerotic renovascular disease were followed by a single renal unit. Angiotensin converting enzyme inhibitors were being taken by 22% of patients at the time of diagnosis of the atherosclerotic renovascular disease. Intervention to revascularize renal tissue by surgery or angioplasty was performed in 32 patients. Revascularization was not undertaken because of unilateral disease, patient preference, poor operative risk or renal size. The mean age for the nonintervention group was 66.9 years and 63.4 years for the intervention group. Peripheral vascular, disease was common in both groups (96% nonintervention group versus 86% intervention group). There was a statistically significant difference in improvement in renal function in the intervention group (34.4% versus 10.7%) in spite of more patients being dialysis dependent in the intervention group (28.1% versus 14.3%). There was no statistically significant difference in survival between the two groups although the trend was for better survival in the group with intervention. Patients presenting with impaired renal function and atherosclerotic renovascular disease can have useful improvement in renal function with revascularization without any detriment to survival.
在6年期间，一个肾脏单元对60例动脉粥样硬化性肾血管疾病患者进行了随访。在诊断动脉粥样硬化性肾血管疾病时，22%的患者正在服用血管紧张素转换酶抑制剂。32例患者接受了通过手术或血管成形术使肾组织血管再通的干预措施。由于单侧疾病、患者偏好、手术风险高或肾脏体积小，未进行血管再通。非干预组的平均年龄为66.9岁，干预组为63.4岁。两组外周血管疾病均很常见（非干预组为96%，干预组为86%）。尽管干预组中更多患者依赖透析（28.1%对14.3%），但干预组肾功能改善有统计学显著差异（34.4%对10.7%）。两组间生存率无统计学显著差异，尽管趋势是干预组生存率更高。肾功能受损且患有动脉粥样硬化性肾血管疾病的患者通过血管再通可使肾功能得到有效改善，且对生存无任何损害。
