动脉粥样硬化性肾动脉狭窄与高血压相关性的MDCTA研究

目的利用MDCTA评价动脉粥样硬化性肾动脉狭窄与高血压之间的相关性。方法对42例动脉粥样硬化性肾动脉狭窄的高血压患者的多层螺旋CT血管成像进行重建、分析,判断肾动脉狭窄的程度,对观察者间的一致性进行评价,并将肾动脉狭窄评分与血压进行相关性分析。结果 MDCTA评价肾动脉狭窄的观察者间一致性较好,kappa值为0.71。42例患者中,22例为双侧肾动脉狭窄,20例为单侧肾动脉狭窄,共64支狭窄肾动脉,其中钙化性斑块32支,混合性斑块21支,非钙化性斑块11支,狭窄部位均为肾动脉近段。肾动脉狭窄评分与收缩压及舒张压呈正的直线相关,相关系数r为0.834,决定系数R2为0.695。结论 MDCTA是评价动脉粥样硬化性肾动脉狭窄的最佳无创性检查手段之一,粥样硬化性肾动脉狭窄的程度与高血压之间存在正性直线相关。

The correlative study between atherosclerotic renal artery stenosis and hypertension by muti-detector CT angiography

Objective To evaluate the correlativity between atheroselerotic renal artery stenosis and hypertension using multi-detector CT angiography. Methods 42 patients with atherosclerotie renal artery stenosis and hypertension under- went MDCTA examination. The CT data were reconstructed and analyzed. Interobserver agreement was evaluated fol lowed by the correlative study between atherosclerotic renal artery stenosis and blood pressure. Results Interobserver a- greement was good （kappa：0.71） in this study. There were bilateral renal artery stenosis in 22 patients and unilateral re nal artery stenosis in 20 patients. 32 calcified plaques, 21 mixed plaques and 11 non-calcified plaques located in proximal renal artery were demonstrated in 64 stenosis renal arteries. Positive linear correlations were showed between renal artery stenosis and systolic/diastolic pressure with correlation coefficient r =0. 834 and coefficient of determination R2- 0. 695. Conclusion MDCTA is one of the most valuable tools in the invasive evaluation of atherosclerotic renal artery stenosis, there is an positive linear correlation between the severity of renal artery stenosis and hypertension.