肾动脉狭窄的介入治疗分析

目的 分析介入治疗肾动脉狭窄（RAS）的疗效。方法自2003年3月至2008年3月共收治45例RAS患者，53支肾动脉中单纯行腔内球囊扩张术（PTA）治疗11支，行球囊扩张及内置支架术（PTA／Stent）治疗者42支，随访9～48个月，检测患者的血压与血肌酐水平，并作肾动脉彩超。结果手术成功率为100％。手术后高血压治愈者9例，改善28例，肾功能改善12例。肌纤维发育不良及多发性大动脉炎的血压改善有效率均为100％，高于动脉粥样硬化的有效率65．1％（P〈0．05）。行彩色多普勒超声检查肾动脉18支，发现再狭窄者7支。结论PTA和PTMStent治疗肾动脉狭窄具有微创、安全、有效的优点。

Analyse of intervention therapy in renal artery stenosis

Objective To analyze the interventional therapeutic effects in renal artery stenosis （RAS） dis Methods Forty-five cases of RAS from March 2003 to March 2008 were admitted in our hospital. Fifty-three renal arteries were found stenosis or obstructed. Of those 11 arteries received percutaneous transluminal angioplasty （PTA） treatment, and other 42 arteries received PTA and stent planting treatment. The cases were followed up in blood pressure, serum creatinine and renal artery colour Doppler for 9 to 48 months. Results All the interventional operation of 45 cases were successful. After operation, the hypertension disappeared in 9 cases,improved in 28 cases, and the renal function improved in 12 cases. The effective rate of hypertension improving was 100% in fihromuscular dysplasia and takayasu disease group, which was much higher than 65.1% of atherosclerotic group（P〈 0.05）. Eighteen arteries were followed up by colour Doppler, and found restenosis in 7 cases. Conclusion The operation of PTA and PTA/stent provides a micro-trauma, safe and effective choice for therapy of RAS disease.