移植肾动脉狭窄的诊断与治疗

目的探讨移植肾动脉狭窄(TRAS)的诊断与治疗方法。方法对13例TRAS患者的临床表现,诊断、治疗情况进行回顾性分析。结果13例患者经彩超检查,10例明确诊断为TRAS,3例可疑诊断,特异性为76.9%,DSA诊断特异性为100%,全部行经皮穿刺移植肾动脉球囊扩张成形术(PTRA)或/和内支架术(IAST)后治愈。结论肾移植术后出现不明原因高血压,尿量减少和血肌肝升高,应考虑是否有移植肾动脉狭窄,彩超可作为筛选及随访手段,移植肾动脉造影是诊断的金标准,PTRA可作为TRAS的首选治疗方法。

Diagnosis and management of transplanted renal artery stenosis

[Objective] To study the diagnosis and management of renal artery stenosis in kidney transplantation. [Methods] 13 cases of transplanted renal artery stenosis (TRAS) were reviewed and studied. [Results] Color-flow doppler has been helpful in the diagnoses for 10 of the 13 cases with a specificity of 76.9% and 3 cases were suspected by Color-flow Doppler. DSA in the diagnoses was 100%. All the patients underwent percutaneous transluminal renal angioplasty (PTRA) or/and intra-arterial stenting and were cured of the renal stenosis in a short term. [Conclusions] TRAS should be considered whenever there is hypertension of unknown cause, a sudden reduce of urine volume and on increase of creatinine after kidney transplantation. Color-flow Doppler is indicated for the screening of TRAS kidney arteriography is gold standard in diagnosis, whereas PTRA is the procedure of first choice for TRAS.