支架置入术治疗粥样硬化性肾动脉狭窄对肾功能疗效的观察

Effects of percutaneous transluminal renal angioplasty with stent on kidney function in patients with atherosclerotic renal artery stenosis

目的 探讨经皮肾动脉内支架置入术 (percutaneoustranslumminalrenalangioplastywithstent,PTRAS)治疗动脉粥样硬化性肾动脉狭窄 (atheroscleroticrenalarterystenosis,ARAS)对肾功能的影响。方法 经肾动脉造影确诊的ARAS并施行PTRAS的患者 17例 ,术后随访 3～ 4 8(16 .3± 14 .8)个月 ,回顾性分析术后患者血清肌酐、血压水平和再狭窄的发生率。结果 17例PTRAS全部成功 ,术后肾功能改善 4例 (2 3.5 3% ) ,肾功能稳定 9例 (5 2 .93% ) ,总有效率达到 76 .4 7% (13 17例 ) ;肾功能恶化 4例 (2 3.5 3% )。随访长达 2 4～ 4 8个月的 7例患者有 6例肾功能稳定。血压下降或药物控制使血压 <14 0 90mmHg(1mmHg=0 .133kPa) 15例 (88.2 4 % ) ,发生再狭窄 4例 (2 3.5 3% )。结论 PTRAS治疗ARAS能够使肾功能改善或稳定 ,部分患者肾功能长期稳定。

Objective To investigate the effects of percutaneous transluminal renal angioplasty with stent (PTRAS) on kidney function in patients with atherosclerotic renal artery stenosis (ARAS).Methods Seventeen cases of ARAS diagnosed with renal angiography received PTRAS and were followed up for 3～48 months (average 16.3±14.8 months). Postoperative data of serum creatinine, level of blood pressure and occurrence of restenosis were collected and analyzed.Results Seventeen cases receiving PTRAS were all technically successful. Renal function improved in 4 cases (23.53%), kept stable in 9 cases (52.93%), and declined in 4 cases (23.53%). Seven cases were followed up for as long as 24～48 months and 6 of them had stable kidney function. Blood pressure <140/90 mm Hg (1 mm Hg=0.133 kPa) was found in 15 cases, with or without hypotensive treatment.Restenosis happened in 4 cases (23.53%).Conclusions PTRAS is an effective treatment for ARAS patients. It could improve or maintain kidney function in 76.47% of patients and some of the patients had long-term benefits.