大动脉炎肾动脉狭窄或闭塞介入治疗临床效果观察

目的研究介入治疗在治疗大动脉炎肾动脉狭窄或闭塞的临床效果以及并发症。方法选取2007年3月至2012年3月在河北大学附属医院经实验室检查和血管造影诊断为大动脉炎肾动脉狭窄或闭塞的患者150例,分为介入治疗（A组）和外科手术（B组）两组,比较两组临床效果以及并发症。结果 A组手术时间、术中出血量、出院时间分别为（45.2±2.1）min、（51.4±3.5）mL、（5.70±0.45）d,显著低于B组,差异有统计学意义（P〈0.05）。A组经治疗6个月后,其收缩压、舒张压、肾小球滤过率以及血肌酐分别为（145.6±11.3）mm Hg、（75.6±7.2）mm Hg、（127.8±6.7）mL/min、（85.7±9.1）μmol/L,比治疗前有显著改善,差异有统计学意义（P〈0.05）;而B组在治疗6个月后,与治疗前差异无统计学意义（P＞0.05）。同时A组患者的成功率、再狭窄率以及总并发症发生率分别为93.3%、12.0%、17.3%,明显低于B组,差异有统计学意义（P〈0.05）。结论介入治疗大动脉炎肾动脉狭窄或闭塞成功率高,并发症少,临床应用价值高。

Clinical effects of interventional therapy for the treatment of Takayasu arteritis renal artery stenosis or occlusion

Objective To investigate the clinical effects and complications of interventional therapy for the treatment of Takayasu arteritis renal artery stenosis or occlusion.Methods A total of 150patients with Takayasu arteritis renal artery stenosis or occlusion,treated in this hospital during Mar.2007and Mar.2012,were enrolled and divided into interventional therapy group（group A）and surgical operation group（group B）.Clinical effects and complication were compared between the two groups.Results In group A,the time of surgery,amount of bleeding and duration of hospital stays were respectively（45.2±2.1）min,（51.4±3.5）mL and（5.70±0.45）d,which were obviously lower than group B（P〈0.05）.After six-month′s treatment,systolic pressure,diastolic pressure,glomerular filtration rate and serum creatinine level in group were（145.6±11.3）mm Hg,（75.6±7.2）mm Hg,（127.8±6.7）mL/min and（85.7±9.1）μmol/L respectively,which were obviously better than before treatment（P〈0.05）,but all indexes were not with significant difference in group B before and after treatment（P〉0.05）.The success rate,stenosis rate and total incidence rate of complications in group A were 93.3%,12.0% and 17.3%respectively,which were obviously lower than that group B（P〈0.05）.Conclusion For the treatment of Takayasu arteritis renal artery stenosis and occlusion,interventional therapy could be with high success rate,less complications and significant value for clinical application.