顽固性高血压肾动脉造影的临床研究

目的探讨肾动脉造影对肾动脉狭窄（RAS）的顽固性高血压的诊断价值。方法选取2012年11月～2014年3月本院收治的50例临床上高度怀疑RAS的顽固性高血压患者,分别行DSA和彩色多普勒超声检查。结果DSA检查结果：50例中,45例被诊断为RAS,且狭窄面积多〉50%,其中轻度8例,中度21例,重度16例,诊断率为90%;彩色多普勒超声诊断结果：25例被诊断为RAS,其中轻度6例,中度11例,重度8例,诊断率为50%,DSA对RSA的诊断率高于彩色多普勒超声（P〈0.05）。彩色多普勒超声诊断为RAS的25例患者中,有19例与DSA检查符合,其诊断符合率为76%,误诊率为24%。结论对临床上高度怀疑RAS的顽固性高血压患者行肾动脉造影,能准确诊断肾动脉狭窄情况,降低误诊、漏诊率,从而使患者得到及时有效的治疗,对保障患者的生活质量与生命安全有重要意义。

Clinical study of renal artery angiography for resistant hypertension

Objective To study the diagnostic value of renal artery angiography for renal artery stenosis（RAS） in resistant hypertension. Methods 50 patients with resistant hypertension caused by RAS highly suspected from November2012 to March 2014 were selected and were given the examination of digital subtraction angiography（DSA） and color Doppler ultrasound. Results DSA examination results：among 50 patients, 45 cases were diagnosed as RAS,most of stenosis area was more than 50%,and 8 cases were light,21 cases were moderate,16 cases were severe,the diagnostic rate was 90%;the results of color Doppler ultrasound examination：25 cases were diagnosed as RAS,6 cases were light,11 cases were moderate,8 cases were severe,the diagnostic rate was 50%,the diagnostic rate of DSA for RAS was higher than that of color Doppler ultrasound（P〈0.05）.Among 25 cases with RAS diagnosed by color Doppler ultrasound,19 cases were diagnosed as RAS by DSA,and the diagnostic accordance was 76%,the misdiagnostic rate was 24%.Conclusion Renal arteriography used for patients with resistant hypertension caused by RAS highly suspected in clinc can accurately diagnose RAS,and reduce the misdiagnostic and missed diagnostic rate to make patients treated effectively and timely,and it has an important significance for ensuring the quality of life and life safety of patients.