肾动脉狭窄患者介入治疗的长期疗效观察

目的评价经皮肾动脉成形术对肾动脉狭窄患者血压、肾功能的长期影响。方法肾动脉狭窄患者229例(管腔狭窄≥70%),经肾动脉成形术重建肾动脉血运,术后平均随访(13±10)个月,观察患者血压、降压药物、肾功能的变化。结果229例患者肾动脉成形术成功率96.1%。病变动脉管腔直径狭窄率由70%±11%降至12%±10%。术后随访138例患者,血压由治疗前的(151±25/82±15)mmHg降至治疗后的(137±16/77±11)mmHg,差异有统计学意义(P<0.01),口服降压药由(2.4±1.2)种降至(1.8±0.9)种,差异均有统计学意义(P<0.01);患者手术前后肌酐水平(SCr)及肾小球滤过率(GFR)比较差异无统计学意义(P>0.05)。结论肾动脉狭窄患者经皮肾动脉成形术的手术成功率高,有助于此类患者血压的长期良好控制。

Long term follow up the therapeutic effect of renal artery revascularization on renal artery stenosis

Objective To follow up the long term effects of blood pressure and renal function after the renal artery angioplasty and stenting in patients with renal artery stenosis.Methods Totally 229 patients with renal artery stenosis underwent percutaneous transluminal renal artery angioplasty/stents.The blood pressure,serum createnine and glomerular filtration rate were followed-up in long term（13±10） months.Results There were 96.1%of all 201 patients received renal artery revascularization successfully.The renal arteries stenoses were decreased from 70%±11%to 12%±10%after operation.The blood pressure of 138 followed-up patients were significantly decreased from （151±25/82±15） mmHg to（137±16/77±11） mmHg（P0.01）.The number of anti-hypertensive drugs were significantly decreased from 2.4±1.2 to 1.8±0.9（P0.01）.Furthermore,the serum createtine level and glomerular filtration rate（GFR）did not change significantly in follow up period（P0.05）.Conclusion The successfully of percutaneous transluminal renal artery angioplasty/stents was pretty good for patients with renal artery stenosis,and blood pressure control were benefited in long term from it.