Effects of renal artery stenting on renal function and blood pressure in patients with atherosclerotic renovascular disease

Objective To study the effects of percutaneous renal artery intervention on renal function and blood pressure in patients with renal artery stenosis. Methods Eighty-seven patients with severe uni- or bi-lateral renal artery stenosis (luminal diameter narrowing ≥70%) and clinical hypertension received renal artery stenting between January 2002 and December 2002. The changes in blood pressure and serum creatinine level and creatinine clearance (CCr) 48 hours after intervention and during 6 months of follow-up were assessed.Results Renal stenting was performed in 98 stenotic arteries of 87 patients, and the procedural success rate was 100%. Serum creatinine level was slightly elevated from (176±21) μmol/L to (179±11) μmol/L (P=0.15) 48 hours after the procedure, but significantly decreased to (149±15) μmol/L at 6 months (P<0.001). CCr was also greatly improved ［(37±11) ml/min before versus (51±8) ml/min at 6 months, P<0.001］. During follow-up, 61% of the patients experienced a normal renal function. Despite conventional medical treatment, systolic and diastolic blood pressures were also significantly decreased after stenting ［(163±23)/(96±13) mm Hg before versus (148±12)/(79±15) mm Hg at 6 months, all P<0.001］, and hypertension was well controlled in 67% of the patients at 6 months’ follow-up.Conclusion Renal artery stenting has a high success rate and is effective in improving renal function and blood pressure for patients with severe renal artery stenosis.     

Delayed recovery of renal function in patients with acute renal failure due to accelerated hypertension

Five patients with acute renal failure due to accelerated hypertension required regular dialysis treatment for 2-12 months (mean 8.8), before recovering sufficient renal function for dialysis to be withdrawn. Two patients who had prior evidence of chronic renal impairment remained off dialysis for 20 and 27 months before decompensating again to require regular dialysis treatment. Two patients with no prior history of renal disease have remained independent of dialysis for 32 and 48 months. The fifth patient was lost to follow-up after a 7 month dialysis-free period. Delayed recovery of renal function following accelerated hypertension is a distinct possibility and should be considered in such patients before contemplating long term strategies such as renal transplantation.     

不同血液净化方案对尿毒症难治性高血压的疗效观察

目的 探讨持续不卧床腹膜透析(CAPD)、血液透析滤过(HDF)对并发难治性高血压的单纯规律血液透析(HD)患者的临床疗效.方法 68例HD伴难治性高血压患者随机分为CAPD、HDF/HD两组.CAPD组每天腹透液总量8 000ml,晚上留腹2 000ml;HDF/HD组每周采用2次血液透析加1次血液透析滤过治疗,治疗时间为3个月.比较两组患者治疗前后平均动脉压、BUN及Cr的变化.结果 与治疗前相比,治疗后两组平均动脉压水平、BUN与Cr水平均较治疗前明显下降,其差异有统计学意义(P＜0.05).治疗后CAPD组与HDF/HD组相比,平均动脉压水平亦明显下降,其差异有统计学意义(P＜0.05);但BUN与Cr水平两组相比无统计学意义(P＞0.05).结论 对于尿毒症难治性高血压患者血压的控制HDF/HD与CAPD均为有效的治疗方法,但CAPD效果更佳.     

不同透析方式对老年终末期肾病患者动态动脉硬化指数(AASI)的影响分析

选择本院肾病内科收治的114例老年终末期肾病患者分为腹膜透析组和血液透析组,各57人。使用动态血压仪监测血压,记录患者治疗前,治疗后3、6、12个月后的动态血压变化值,利用血压值计算动脉硬化指数(AASI),检测患者血清中PTH、Hb、TC含量。透析6、12个月后,2组患者的AASI及收缩压明显高于透析前;3、6、12个月后,腹透组的血钙含量、透析充分性指标KT/V、Ccr及血清中PTH、Hb、TC含量明显优于血透组;且感染率明显少于血透组。不同透析方式对老年终末期肾病患者的动态动脉硬化指数的变化无明显影响,但改善了患者的钙代谢指数及透析充分性指标。     

对健康体检中发现高血压患者实施健康教育干预的效果观察

目的对健康体检中发现的高血压患者实施健康教育干预的效果进行观察,旨在强化体检者意识到高血压的危害性,逐步提高其健康意识。方法随机选择我院2010年1月-2011年1月进行健康体检发现的100例原发性高血压患者作为研究对象,观察实施健康教育干预前及干预后6、12个月患者在饮食不合理、体重指数〉25kg／m^2、运动〈30min／d、吸烟、疾病知识掌握情况、自觉心理压力方面的变化情况。结果干预后6个月后、12个月后饮食不合理、体重指数〉25kg／m^2、运动〈30min／d、吸烟、疾病知识掌握情况、自觉心理压力方面的比率明显好于干预前（P〈0．05）。干预后6个月、12个月的收缩压、舒张压明显低于干预前（P〈0．05）。结论对健康体检中发现高血压患者实施健康教育干预具有较好的效果,值得推广和应用。     

Beneficial effects of angiotensin converting enzyme inhibition on renal function in patients with diabetic nephropathy

The effects of angiotensin converting enzyme inhibition with captopril were investigated in patients with diabetic nephropathy and hypertension. After nine days' treatment with captopril glomerular filtration rate was unchanged in 13 patients, whereas renal plasma flow had increased from 265 to 302 ml/min/1.73 m2 body surface area (p less than 0.05) and the filtration fraction had decreased from 14.3 to 12.8% (p less than 0.025). During two years' treatment with captopril in 14 patients the mean arterial blood pressure had fallen by 5 mm Hg (p less than 0.005) and the deterioration in glomerular filtration rate had decreased from 10.3 to 2.4 ml/min/year (p less than 0.005). There was no correlation between the fall in blood pressure and the reduction in the deterioration of glomerular filtration rate. These findings suggest that the effects of angiotensin converting enzyme inhibition on renal haemodynamics protect renal function. Inhibitors of angiotensin converting enzyme should be considered for lowering blood pressure in patients with diabetic nephropathy.     

Converting enzyme inhibition and kidney function in normotensive diabetic patients with persistent microalbuminuria

The effects of a long term reduction in blood pressure on the kidney function of normotensive diabetic patients who had persistent microalbuminuria (30-300 mg albumin/24 hours) were studied in two groups of 10 such patients before and during six months of treatment with either 20 mg enalapril or placebo daily. Treatments were assigned randomly in a double blind fashion. Before treatment both groups had similar clinical characteristics, weight, diet, total glycosylated haemoglobin, median albumin excretion rate (enalapril group 124 mg/24 h, placebo group 81 mg/24 h), and mean arterial pressure (enalapril group 100 (SD 8) mm Hg, placebo group 99 (6) mm Hg). During treatment weight, urinary urea excretion, and total glycosylated haemoglobin remained unchanged. The mean arterial pressure decreased in the enalapril group but not in the placebo group (enalapril group 90 (10) mm Hg, placebo group 98 (8) mm Hg). The median albumin excretion rate also fell in the enalapril group but not in the placebo group (enalapril group 37 mg/24 h, placebo group 183 mg/24 h.) The glomerular filtration rate rose in the enalapril group from 130 (23) ml/min/1.73 m2 to 141 (24) ml/min/1.73 m2, and total renal resistances and fractional albumin clearance decreased while fractional albumin clearance increased in the placebo group. These results show that in patients who have diabetes but not hypertension a reduction in blood pressure by inhibition of converting enzyme for six months can reduce persistent microalbuminuria, perhaps by decreasing the intraglomerular pressure.     

透析液钠离子浓度对血液透析患者血压的影响

目的探讨透析液钠离子浓度的改变对维持性血液透析患者血压的影响。方法选择2009年7月-2012年2月在我院血液净化中心进行血液透析的30例维持性血液透析的高血压患者,分别给予透析液钠离子浓度为140mmol/L(透析模式A)和透析液钠离子浓度为135 mmol/L(透析模式B)的透析模式各透析3个月,采用自身对照,观察患者前3个月和后3个月血压的变化。结果通过6个月的观察发现,透析模式B的患者透析后与透析前比较,血压显著改善,差异有统计学意义(t=10.037、18.139,P<0.01);透析模式A的患者透析后与透析前比较,差异无统计学意义(t=-0.218、0.264,P>0.05)。结论透析模式B的血压控制显著优于透析模式A,降低透析液钠离子的浓度可以降低维持性血液透析高血压患者高血压的发生。     

HYPERTENSION IN RENAL ALLOGRAFT RECIPIENTS

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IgA肾病合并高血压病88例临床病理特点分析

目的：研究合并高血压病的原发性IgA肾病（IgAN）的临床病理特点。方法：对2007年1月-2013年6月在我院肾内科经肾活检证实为IgAN且临床诊断高血压病的88例患者的临床病理资料进行回顾性分析。结果：IgAN合并高血压病患者平均年龄（44.7±11.27）岁。其中有高血压家族史48例,占54.5%。高血压病史（中位数为36个月）长于IgAN病史（中位数为2个月）,P＜0.01。临床表现主要为无症状尿检异常,共66例（占75.0%）;其次是肾病综合征和慢性肾炎（分别占10.2%和11.4%）。肾小球滤过率估算值（eGFR）＜90 mL/min 29例（占33.0%）,其中伴低尿渗透压6例（6/9）,伴尿N-乙酰-β-D氨基葡萄糖苷酶（NAG）升高21例（21/29）;伴左室壁增厚和（或）左房增大52例（52/87）;伴高血压视网膜病变76例（76/80）。肾活检病理显示Haas 1级～3级病变合计占87.5%,重度肾小球硬化占19.3%,中重度肾间质病变占34.1%,肾细小动脉病变占78.4%。结论：合并高血压病的IgAN患者肾脏临床病理表现多数较轻;部分存在肾小球滤过功能异常者多合并肾小管功能异常,部分病例较重的肾小管间质病变与肾小球病变程度不平行,普遍存在肾细小动脉病变。对于合并高血压病的IgAN病例而言,高血压可能是影响肾脏预后的主要因素。     

不同透析方式对尿毒症患者生存质量的影响

[目的]探讨延长透析时间,并采用降低血流量与降低透析液流量对尿毒症患者心血管系统的影响。[方法]选取2009年5月至2011年5月本院肾病内科诊治的60例血液透析患者,按照随机配对原则将患者分为试验组和对照组,试验组30例,每次透析时间为8～10 h ,透析液流量300 mL/min ,血流量150～200 mL/min ,透析频率隔日一次;对照组30例,每次透析时间4．5 h ,透析液流量500 mL/min ,血流量250 mL/min ,透析频率隔日一次。比较两组患者心血管事件发生概率,超声心动图监测治疗前后心功能指标的变化。[结果]试验组患者高血压、低血压、心力衰竭、心律失常等心血管事件总发生率为12．36％（267/1260）较对照组26．88％（582/2165）显著降低,且两者相比较差异有显著性（ P ＜0．05）;试验组透析后心脏收缩功能指标：每分搏出量、左心射血分数和左心室质量指数以及舒张功能指标均较治疗前明显好转（ P ＜0．05）,对照组各项指标治疗前后无明显变化（ P ＞0．05）;试验组治疗后的效果显著优于对照组,且两者相比较差异有显著性（ P ＜0．05）。[结论]长时透析和采用低透析液流量、低血流量能够显著降低血压,改善心功能,逆转左心室重构,提高患者生存质量,值得临床推广。     

Malignant hypertension in women of childbearing age and its relation to the contraceptive pill

Eleven of 34 women aged 15-44 with malignant phase hypertension were taking oral contraceptives at presentation. All had had normal blood pressure before starting to take the pill. In four the interval between the start of oral contraception and the diagnosis of malignant hypertension was less than four months, and in eight no other cause for the hypertension was found. Underlying renal disease and renal failure were less common among pill users than among non-users with malignant hypertension who were of similar age. No pill user became normotensive after withdrawal of the pill, but blood pressure was well controlled (diastolic less than 90 mm Hg) in three patients taking only one drug. By contrast, all 23 non-users needed two or more antihypertensive drugs to control blood pressure. Ten year survival was 90% among pill users and 50% among non-users. These results suggest that oral contraceptives may be a common cause of malignant hypertension in women of child-bearing age. If the pill is stopped and underlying renal disease excluded the long term prognosis for such patients is excellent.     

动静脉内瘘血流量对慢性血液透析患者心功能及血清Cystatin C、Hcy、BNP水平的影响

目的 探讨动静脉内瘘血流量对慢性血液透析患者心功能及血清Cystatin C、Hcy、BNP水平的影响。方法 选取2015年4月至2018年3月在我院采用动静脉内瘘行血液透析治疗的80例慢性肾功能衰竭患者,根据动静脉内瘘血流量（AVFB）水平分为低流量组（<400 ml /min）;中流量组（400 ml /min -600 ml /min）;高流量组（>600 ml /min）。术后1个月开始使用内瘘时和1年后行超声心动图检测心功能指标,同时检测血清Cystatin C、Hcy、BNP水平,并分析AVFB与其之间的关系。结果 透析前三组患者的CO、CI、EF、LAD、LVDd、LVDs、E、A和E/A均无明显差异（均P>0.05）;透析1年后高流量组患者的CO、CI、EF、LAD、LVDd、LVDs和E/A明显高于低流量组和中流量组,差异具有统计学意义（均P<0.05）,而中流量组与低流量组患者心功能指标互相比较均无统计学差异（均P>0.05）;透析1年后高流量组及中流量组患者的CI、EF、LAD明显高于透析前,差异具有统计学意义（均P<0.05）,其CO、LVDd、E、A和E/A也明显高于透析前,差异具有统计学意义（均P<0.01）;透析1年后高流量组的LVDs 高于透析前（P<0.05）。透析前三组患者的血清的Cystatin C、Hcy、BNP均无明显差异（均P>0.05）;透析1年后高流量组患者的Cystatin C、Hcy、BNP明显高于低流量组和中流量组,差异具有统计学意义（均P<0.05）,而中流量组与低流量组患者的Cystatin C、Hcy、BNP指标互相比较均无统计学差异;透析1年后高流量组和中流量组患者的Cystatin C明显高于透析前,差异具有统计学意义（P<0.01）,而Hcy水平明显低于透析前,差异具有统计学意义（P<0.01）。AVFB 与Cystatin C呈正相关(r=0.648,P＜0.05),与Hcy、BNP呈负相关（r=0.542、0.147,P＜0.05）。结论 AVFB与心功能密切相关,AVF的通畅可以减弱心功能的影响;AVFB与Cystatin C呈正相关,与Hcy、BNP呈负相关。     

Arterial hypertension and renal allograft survival

CONTEXT: Several observational studies have investigated the significance of hypertension in renal allograft failure; however, these studies have been complicated by the lack of adjustment for baseline renal function, leaving the role of elevated blood pressure in allograft failure unclear. OBJECTIVE: To examine the relationship between blood pressure adjusted for renal function and survival after cadaveric allograft transplantation. DESIGN: Nonconcurrent historical cohort study conducted from 1985 through 1997. SETTING: University teaching hospital. PARTICIPANTS: A total of 277 patients aged 18 years or older who underwent cadaveric renal transplantation without another simultaneous organ transplantation and whose allograft was functioning for a minimum of 1 year. Follow-up continued through 1997 (mean follow-up, 5.7 years). MAIN OUTCOME MEASURE: Time to allograft failure (defined as death, return to dialysis, or retransplantation) by systolic, diastolic, and mean arterial blood pressure measurements at 1 year after transplantation. RESULTS: Multivariate Cox proportional hazards modeling demonstrated that nonwhite ethnicity, history of acute rejection, and nondiabetic kidney disease were significant predictors of failure (P = .01 for all). In addition, the calculated creatinine clearance at 1 year had an adjusted rate ratio (RR) for allograft failure per 10 mL/min (0.17 mL/s) of 0.74 (95% confidence interval [CI], 0.62-0.88). The RR per 10-mm Hg increase in blood pressure measured at 1 year after transplantation, after adjustment for creatinine clearance, was 1.15 (95% CI, 1.02-1.30) for systolic pressure, 1.27 (95% CI, 1.01-1.60) for diastolic pressure, and 1.30 (95% CI, 1.05-1.61) for mean arterial pressure. Supplemental analyses that did not include death as a failure event or reduce the minimum allograft survival time for study subjects to 6 months yielded results consistent with the primary analysis. There was no evidence of modification of the blood pressure-allograft failure relationship by ethnicity or diabetes mellitus. CONCLUSIONS: Systolic, diastolic, and mean arterial blood pressures at 1 year posttransplantation strongly predict allograft survival adjusted for baseline renal function. More aggressive control of blood pressure may prolong cadaveric allograft survival.     

血液透析提早干预糖尿病肾病的临床研究

目的 探讨性将糖尿病肾病患者提早进入治疗血液透析,观察对心脑血管事件发生及生存质量产生的影响.方法 选2005-03～2009-03在广西血液净化中心治疗的糖尿病肾病患者68例（肌酐清除率（Ccr）≤30 ml/min,但≥15 ml/min,出现水肿,血压、血糖控制良好）,随机分为观察组33例,入组后,立即进入血液透析治疗,每周3次,每次治疗时间4.5 h,维持2年;对照组35例,入选后给按肾衰一体化予保守治疗,等待至Ccr下降达到≤15 ml/min才开始进入血液透析治疗,每周3次,每次治疗时间4.5 h,维持2年.观察并记录两组患者从入组至血液透析2年后,心脑血管事件即：心力衰竭、心绞痛、心肌梗死、心脏猝死、恶性心律失常、脑血管病变及高血压的发生发展情况.结果 观察组心脑血管事件及高血压的发生率显著低于对照组（P＜0.01）,两组同一患者在发生2种以上的心脑血管事件及先后累计发生4例次以上心脑血管事件的比较差异有统计学意义（P＜0.05）,主要的心血管事件为心力衰竭,其次为缺血性心脏病;两组病死率差异无统计学意义（P＞0.05）;两组入组与研究结束时的肾功能、血清白蛋白（ALB）差异有统计学意义（P＜0.01）,血糖差异则无统计学意义（P＞0.05）,而对照组中,进入透析时的ALB与刚入组时及透析2年后相比较,差异均有统计学意义（P＜0.01）;两组研究结束时的肾功能、ALB、血糖差异无统计学意义（P＞0.05）.结论 对于出现水肿的糖尿病肾病患者,一旦Ccr≤30 ml/min,主动地提前干预性进入规律血液透析,能够有效降低糖尿病肾病的心脑血管事件的发生率,提高生存质量;提早进入血液透析,虽然不能延缓肾功能损害的进展,但能显著改善低蛋白血症的状况.     

腔内隔绝术治疗胸主动脉夹层动脉瘤对血压和肾功能的影响

目的：通过对Stanford B型胸主动脉夹层动脉瘤腔内隔绝术前后患者血压和肾功能变化的观察，初步探讨此术式对患者血压和肾功能的影响及其可能机制。方法：共观察111例。以平卧位右上肢肱动脉无创血压为标准，术前和术后2周、3个月进行观察。术前、术后1周内每日、术后1个月检查患者血尿素氮和肌酐。测量患者术前、术后降主动脉真腔内径、肾动脉内径，了解肾脏真、假腔供血情况。结果：术前并存高血压82例，术后高血压改善34例（41.55）。术前肾功能正常者94例，术后肾功能无明显变化；术前肾功能异常者17例，术后出现肾功能异常一过性加重。术后肾动脉内径增大2例，高血压均明显改善，肾功能无明显改善。术后肾动脉恢复真腔供血9例中，6例高血压改善，肾功能均无明显改善。术后主动脉真腔明显增粗11例，7例高血压改善，结论：手术对患者血压的影响主要为在原有高血压基础上的改善，术后肾脏血供的改善、主动脉真腔增粗，血流阻力降低，可能是改善高血压的机制。手术对患者肾功能影响较小，主要依赖于患者本身肾功能情况。     

Effect of medical ozone therapy on renal blood flow and renal function of patients with chronic severe hepatitis

Background Medical ozone therapy system was reported to have certain effects on the treatment of severe hepatitis, but its mechanism is not very clear. One of the causes of death of severe hepatitis is complication of renal damage or hepatorenal syndrome. The present study aimed to observe effects of medical ozone therapy system on plasma renin activity （PRA）, angiotensin II （All）, aldosterone （ALD）, renal blood flow and renal function of patients with chronic severe hepatitis and explore mechanisms of medical ozone therapy in the treatment of severe hepatitis. Methods Eighty-five cases with chronic severe hepatitis were randomly divided into ozone therapy group （43 cases） and control group （42 cases）. The patients in the ozone therapy group were treated with basic treatments plus ozone therapy system. Basic autohemotherapy was used. One hundred milliliter venous blood was drawn from each patient, and was mixed with 100 ml （35 pg/ml） medical ozone and then was returned the blood to the patient intravenously, once every other day for 20 days. Only the basic treatments were given to the control group. PRA, All, ALD, renal blood flow and damage to renal function of the two groups before treatment and 20 days after treatment were compared. Survival rates were also compared. Results Twenty days after the treatment, in ozone therapy group, PRA was （1.31±0.12） ng.m^-1.h^1, All （111.25±17.35） pg/ml, ALD （251.31±22.60） pg/ml, which decreased significantly compared with those before treatment （PRA （2.23±0.13） ng.ml^-1.h^-1, All （155.18±19.13） pg/ml, ALD （405.31±29.88） pg/ml, t=4.67-14.23, P 〈0.01 ）, also lower than those of control group 20 days after the treatment （PRA （2.02±0.11） ng.ml^-1.h^-1, All （162.21±15.32） pg/ml, ALD （401.20±35.02） pg/ml, t=4.97-15.61, P 〈0.01）; renal blood flow was （175.15±28.20） ml/min, which increased compared with that before the treatment （（125.68±21.25） ml/min） and was higher than that of control group 20 days after the treatment （（128.59±23.15） ml/min, t=4.78, 4.61, P 〈0.01）. Renal damage occurred in 2 cases （5%） in ozone therapy group, less than that in control group （9 cases, 21%） （X^2=5.295, P 〈0.05）. Thirty-three cases （77%） in ozone therapy group vs. 16 cases （38%） in control group survived （X^2=12.993, P 〈0.01 ）. Conclusions Basic treatment plus medical ozone therapy for patients with chronic severe hepatitis could decrease PRA, All and ALD levels significantly increase renal blood flow, prevent renal damage to certain extent and improve survival rate of the patients.     

不同透析液流量对联机血液透析滤过效率的影响

目的 比较不同透析液流量对透析患者血清肌酐(creatinine,CREA)、尿素氮(blood urea nitrogen,BUN)、甲状旁腺激素(parathyroid hormone,PTH)、β2-微球蛋白(β2-microglobulin,β2-MG)清除率的影响.方法 选择我科维持性血液透析并且行联机血液透析滤过(Hemodiafiltration,HDF)治疗的患者32例,分别给予550ml/min、650ml/min、750ml/min三种不同透析液流量进行透析,检测不同透析液流量下透析前后CREA、BUN、PTH、β2-MG水平,评估透析效率.结果与透析液流量为550ml/min时比较,透析液流量为650ml/min时,血清CREA、BUN、PTH清除率及尿素清除率(KT/V)均呈增加趋势,但无统计学差异(t分别为0.97,0.95,0.130和1.64,P＞0.05),血清β2-MG清除率明显增加,差异具有统计学意义(t=3.45,P＜0.05).与透析液流量为550ml/min时比较,透析液流量为750ml/min时CREA、BUN、PTH、β2-MG清除率及KT/V均显著增加(t分别为3.45,2.79,3.32,4.73和3.04,P＜0.05).但与透析液流量为650ml/min比较,透析液流量为750ml/min时CREA、BUN、PTH、β2-MG清除率及KT/V清除率比较差异无统计学意义(t分别为1.32,1.87,2.01,0.49和1.63,P＞0.05).结论 联机HDF治疗时,提高透析液流量对尿毒症患者CREA、BUN、PTH、β2-MG的清除更为有效.     

经脐单孔多通道腹腔镜下放置腹透管的初步尝试

目的尝试应用经脐单孔多通道腹腔镜下放置腹透管,总结初步应用体会。方法 2009年5至8月对2例慢性肾功能衰竭且需行腹膜透析的患者行经脐单孔多通道腹腔镜下放置腹透管。结果手术顺利完成,时间分别为15、25min,出血约20ml,未额外增加工作通道,术后1d出院。结论经脐单孔多通道腹腔镜下放置腹透管安全、有效,术后无明显手术瘢痕,美容效果良好。     

粥样硬化性肾动脉狭窄的腔内治疗及术前评估

目的 评价腔内治疗粥样硬化性肾动脉狭窄(ARAS)的效果,探讨术前评估指标.方法 回顾性分析2008年1月至2016年5月海南省人民医院血管外科应用经皮肾动脉支架成形术(PTRAS)治疗的56例单侧ARAS患者的临床资料.检测并比较术前和术后随访期间患者肾动脉狭窄率、阻力指数(RI)、收缩期峰值流速(PSV)、收缩压、舒张压、服用降压药物种数、肾小球滤过率(GFR)、血肌酐(SCr)等指标.根据术后6个月肾功能和/或高血压改善情况将患者分为有效组42例和无效组14例,比较两组患者术前各项指标.结果 本组56例患者成功完成PTRAS;术后6个月随访结果显示,治疗侧肾动脉狭窄率(13.7±1.3)％、RI(0.61±0.07)、PSV(85.7±10.8)cm/s、收缩压(135.1±9.2)mmHg、舒张压(87.9±7.4)mmHg、服用降压药物(1.6±0.4)种、SCr(132.3±20.8)μmol/L、GFR(58.5±6.0)mL/min,分别与术前对比,除舒张压以外的其他各项指标均显著性改善,差异均有统计学意义(P<0.05);有效组和无效组患者术前的高血压病程、收缩压、SCr、GFR、血管紧张素(Ang)Ⅱ浓度、合并糖尿病等指标比较,差异均有统计学意义(P<0.05).结论 PTRAS治疗ARAS具有较好的总体疗效,而术前评估相关指标有助于预测PTRAS的个体疗效.