Tykarski A, Edwards R, Dominiczak A F, Reid J L
University Department of Medicine and Therapeutics, Western Infirmary, Glasgow, UK.
J Hum Hypertens. 1993 Oct;7(5):491-6.
Percutaneous transluminal renal angioplasty (PTRA) is an accepted method of treatment of hypertension resulting from renal artery stenosis. There is less information on the role of PTRA in patients with renal artery disease and renal impairment. We report on 30 patients who underwent PTRA for renal artery stenosis (13 had uncontrolled hypertension and normal renal function and 17 had hypertension and renal insufficiency; 26 patients had atheromatous disease, fibromuscular dysplasia was diagnosed in 2 and 2 patients had renal artery stenosis to a transplant kidney). These 30 patients had 43 PTRA procedures, with the 'initial technical success' rate of 81% and the 'overall success' rate of 79% after ten months. Results of renal PTRA on BP showed the initial benefit in 88% of patients: 71% 'cured' and 17% 'improved'. After ten months only 38% of patients could still be considered 'cured' and 33% 'improved'. Renal function 'improved' in 68% of patients who presented with renal insufficiency. An improvement of BP control or renal function was less likely in patients with bilateral severe atheromatous disease. PTRA is an effective treatment for renal artery stenosis. Satisfactory improvement of BP control and improvement or prevention of further deterioration of renal function may be achieved in a high proportion of patients.
经皮腔内肾血管成形术（PTRA）是治疗肾动脉狭窄所致高血压的一种公认方法。关于PTRA在肾动脉疾病和肾功能损害患者中的作用，相关信息较少。我们报告了30例因肾动脉狭窄接受PTRA治疗的患者（13例患有未控制的高血压且肾功能正常，17例患有高血压和肾功能不全；26例患有动脉粥样硬化疾病，2例诊断为纤维肌性发育异常，2例移植肾出现肾动脉狭窄）。这30例患者共接受了43次PTRA手术，十个月后“初始技术成功率”为81%，“总体成功率”为79%。肾PTRA对血压的影响显示，88%的患者有初始获益：71%“治愈”，17%“改善”。十个月后，只有38%的患者仍可被视为“治愈”，33%“改善”。出现肾功能不全的患者中，68%的肾功能“改善”。双侧严重动脉粥样硬化疾病患者血压控制或肾功能改善的可能性较小。PTRA是治疗肾动脉狭窄的有效方法。在很大一部分患者中可以实现血压控制的满意改善以及肾功能的改善或预防进一步恶化。
