影响介入方法治疗肾血管性高血压疗效的相关因素分析

目的 研究影响介入方法治疗肾血管性高血压疗效的临床相关因素。方法 回顾性分析55例经血管造影证实并行介入治疗的肾血管性高血压患者临床因素与治疗疗效的相关性。结果 介入治疗后，血压改善的有60％(33／55)，无改善的有40％(22／55)。单因素相关性分析发现，介入治疗疗效和患者年龄、发现高血压时间、治疗前舒张压水平、肾动脉狭窄部位、狭窄比例、狭窄病因、血清胆固醇水平和是否合并脑血管病、冠心病等显著相关，而和患者性别、治疗前收缩压水平、血清肌酐和甘油三酯水平、是否合并糖尿病无关。Logistic多因素回归分析发现，年龄、肾动脉狭窄程度和合并脑血管病等是影响介入治疗疗效的独立因素。结论 年龄(≤60岁)，狭窄严重(≥85％)，无脑血管病等合并症的肾血管性高血压患者是介入治疗较好的人选。

Invasive treatment of renovascular hypertension: predictors of outcome

Objective To identify predictors of clinical outcome after invasive treatment of renovas-cular hypertension. Methods In 55 patients,the therapeutic responses were retrospectively assessed after invasive treatment of renovascular hypertension. All patients underwent percutaneous transluminal renal angioplasty,complemented by stent insertion in 34 patients. The role of clinical and angiographic factors for predicting clinical success was analyzed. Results There were 33 successes(33/55,60% ),and 22 failures (22/55,40% ). Predictors of favorable outcome of treatment were younger,shorter duration of hypertension,higher diastolic blood pressure,nonostial stenosis,higher percentage of angiographic stenosis,lower concentration of plasma cholesterol,and no complications of cerebral vascular diseases or of coronary artery diseases. But the other factors,such as sex,systolic blood pressure level,serum creatinine and triglycerol level,were not the predictors of outcome for renovascular hypertension. The Logistic regression analysis showed that age,range of the stenosis and complication of cerebral vascular diseases were the most important predictors of invasive treatment for renovascular hypertension. Conclusion Some clinical and angiographic variables can be used as the predictors of therapeutic success for renovascular hypertension by invasive treatment.