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移植肾动脉狭窄:血管成形术对动脉血压控制和肾功能的长期影响

[Transplant renal artery stenosis: long term effect of angioplasty on arterial pressure control and renal function].

作者信息

al-Najjar A, Halimi J M, Buchler M, Birmelé B, Tranquart F, Alison D, Lebranchu Y

机构信息

Service de néphrologie-transplantation et immunologie clinique, CHU Tours.

出版信息

Arch Mal Coeur Vaiss. 1998 Aug;91(8):1073-6.

PMID:9749168
Abstract

We assessed the long-term (M +/- SE: 68 +/- 3 months) arterial pressure and renal function of cadaveric kidney transplant recipients with and without significant (> 70% diameter reduction) transplant renal artery stenosis (TRAS) at angiography. Baseline clinical, immunological and outcome data for 26 patients with TRAS (incidence of TRAS: 6.6%) before and following angioplasty and 72 patients without stenosis at angiography were reviewed and analyzed. The 2 groups were similar with respect to recipient sex ratio and age (45 vs 46), duration of transplantation (7 months), cause of renal failure, donor sex and age, HLA-antigen mismatches and titers of anti-HLA antibodies, CMV infection and anti-CMV antibodies in donors and recipients. The technical success of angioplasty was 92.3%. Restenosis was documented in 6/26 patients (23.1%). Revascularization resulted in a decrease of arterial pressure and number of antihypertensive medications and a lower serum creatinine compared to baseline values. The long-term arterial pressure and serum creatinine levels were similar in patients with and without stenosis. In conclusion, TRAS after revascularization had no detectable influence on the long-term arterial pressure control and renal function within a follow-up period of 68 +/- 3 months.

摘要

我们评估了尸体肾移植受者在血管造影时有无显著(直径缩小>70%)移植肾动脉狭窄(TRAS)情况下的长期(均值±标准误:68±3个月)动脉血压和肾功能。回顾并分析了26例TRAS患者(TRAS发生率:6.6%)血管成形术前和术后以及72例血管造影无狭窄患者的基线临床、免疫学和结局数据。两组在受者性别比和年龄(45对46)、移植持续时间(7个月)、肾衰竭病因、供者性别和年龄、HLA抗原错配以及抗HLA抗体滴度、巨细胞病毒(CMV)感染以及供者和受者的抗CMV抗体方面相似。血管成形术的技术成功率为92.3%。6/26例患者(23.1%)记录到再狭窄。与基线值相比,血运重建使动脉血压和抗高血压药物数量降低,血清肌酐水平下降。有狭窄和无狭窄患者的长期动脉血压和血清肌酐水平相似。总之,在68±3个月的随访期内,血运重建后的TRAS对长期动脉血压控制和肾功能无明显影响。

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