动脉粥样硬化性肾动脉狭窄的早期发现

探讨冠状动脉造影同时行肾动脉造影的必要性及动脉粥样硬化性肾动脉狭窄的相关危险因素分析。共 4 91例临床疑似冠心病患者行冠状动脉造影同时行非选择性或选择性肾动脉造影 ,并对相关的临床因素进行评价 ,筛选出动脉粥样硬化性肾动脉狭窄的独立危险因素。冠心病组患者中动脉粥样硬化性肾动脉狭窄的发病率为2 0 % ,显著高于非冠心病组 (2 .6 % )。冠心病、外周血管疾病是动脉粥样硬化性肾动脉狭窄的独立危险因素 (多元Logistic回归分析示 ,P <0 .0 0 1、P =0 .0 0 3) ,是其早期发现的指标。对怀疑有冠心病的患者 ,在冠状动脉造影同时行肾动脉造影有助于动脉粥样硬化性肾动脉狭窄的早期发现。

Early Detection of Atherosclerotic Renal Artery Stenosis

Aim To explore the essentiality of renal angiography while undergoing routine coronary angiography and evaluate the correlated risk factor of atherosclerotic renal artery stenosis (ARAS). Methods Abdominal aortography or slective renal angiography was performed immediately after routine coronary angiography in 491 patients with suspected coronary artery disease. Univariate analysis and multivariate Logistic regression analysis were made to evaluate the association of the clinical variables with renal stenosis. Results Incidence of renal artery stenosis was 20% (44/220) in patients with coronary artery disease who were identified by coronary angiography. Only 7 cases with renal artery stenosis were found in 271 cases whose coronary arteries were normal (2.6%). Multivariable predictors of ARAS included coronary artery disease (P<0.001) and peripheral vascular disease (P=0.003). Conclusions Renal angiography should be routinely performed in patients with suspected coronary artery disease while undergoing routine coronary angiography to identify ARAS, especially in patients associated with peripheral vascular disease.