肾动脉支架治疗缺血性肾病的临床研究

目的评价肾动脉支架成形术在缺血性肾病治疗中的临床疗效。方法30例由于肾动脉狭窄引起缺血性肾病的患者,采用经皮肾动脉内支架成形术,共植入支架33枚。随访6~12个月,观察血压、血肌酐、抗高血压药用药情况,并与术前治疗进行比较。结果肾动脉内支架成形术技术成功率为100%,2例患者术中发生肾动脉远端分支栓塞,术后随诊4支血管发生再狭窄。术后血压控制情况其中6例治愈,20例好转,4例无效。术后血肌酐改善10例,无变化15例,恶化5例。结论肾动脉内支架成形术是肾动脉狭窄所致缺血性肾病介入治疗的首选方法,具有较好的安全性和临床疗效。

Clinical study on renal artery stenting in ischemic nephropathy

Objective To evaluate the effects of interventional therapy for ischemic nephropathy. Methods Percutaneous transluminal renal ateries stenting were performed for 30 cases of renal artery stenosis. All the patients were underwent 6-12 months clinical follow-up to observe the level of serum creatinine, blood pressure and number of antihypertensive medications. Result In 30 cases of ischemic nephropathy, 33 stents were successfully implanted. Two cases suffered from distal branch embolization, and 4 cases had restenosis. The blood pressure became normal without taking any antihypertensive medication in 6 cases, the blood pressure control became more facile in 20 cases. However, there was no improvement in 4 cases. Serum creatinine level decreased in 10 cases, remained stable in 15 cases, and increased in 4 cases. Conclusion Renal artery stenting is the first choice in the treatment of ischemic nephropathy causing by renal artery stenosis. Renal artery stenting shows good effects on blood pressure control without renal functions negative changes.