支架成形术治疗粥样硬化性肾动脉狭窄的疗效观察：附27 例报告

目的:探讨支架成形术治疗粥样硬化性肾动脉狭窄(ARAS)的临床疗效.方法:回顾性分析3年来应用支架成形术治疗的27例ARAS患者的临床资料.所有患者术后均定期(术后1,3,6,12个月)随访检测肾动脉狭窄率,肾动脉阻力指数(RI),血压,血肌酐(SCr),肾小球滤过率(GFR)及服用降压药物的种数.结果:27例患者手术均获成功,技术成功率100％.与术前比较,患者术后各时间点各项观察指标均明显改善,差异均有统计学意义(均P＜0.05).1年随访期间,肾动脉再狭窄发生率14.8％(4/27),肾动脉RI改善率92.6％ (25/27),收缩压改善率85.2％ (23/27),舒张压改善率74.1％ (20/27),SCr改善率66.7％(18/27),GFR改善81.5％(22/27),服用降压药物种数减少63.0％(17/27).结论:应用支架成形术治疗ARAS能明显改善肾功能,降低血压,减少口服降压药种类,有较好的安全性和疗效.

Clinical observation of stent-assisted angioplasty for atherosclerotic renal artery stenosis: a report of 27 cases

Objective: To investigate the clinical efficacy of stent-assisted angioplasty for atherosclerotic renal artery stenosis (ARAS). Methods: The clinical data of 27 ARAS patients undergoing stent-assisted angioplasty over 3 years were retrospectively analyzed. All patients were regularly followed after surgery (1 month, and 3, 6, and 12 months, postoperatively), for determination of the stenosis ratio of the renal artery, renal arterial resistive index (RI), blood pressure, serum creatinine (SCr), glomerular filtration rate (GFR) and number of antihypertensive drugs required. Results: Operation was successfully performed in all the 27 patients, and technical success rate was 100%. All the observed parameters of the patients were markedly improved at each observation time point after surgery, and all differences between pre- and post-operative parameters reached statistical significance (all P<0.05). During the 1-year follow-up, the incidence for restenosis of the renal artery was 14.8% (4/27), improvement rates for SCr and GFR were 92.6% (25/27), 85.2% (23/27), 74.1% (20/27), 66.7% (18/27) and 81.5% (22/27) respectively, and number of antihypertensive drugs used was decreased 63.0% (17/27). Conclusion: Application of stent-assisted angioplasty can significantly improve renal function, decrease blood pressure and also reduce the number of antihypertensive medications in ARAS patients, and it has satisfactory safety and efficacy results.