肾动脉狭窄患者的临床特征及介入诊治变迁

Changes in clinical characteristics and interventional modalities of renal artery stenosis in recent years

目的分析近17年来肾动脉狭窄病人的临床特征和介入治疗情况的变化。方法分时间阶段对比总结1987-2004年间144例肾动脉造影患者的临床特征及介入治疗的情况。结果肾动脉造影人数在逐年增多,2000年以前病例平均年龄较小(P<0.05),高血压为主要就诊原因,主要病因是大动脉炎(占52.3%);2000年以后出现因急性肺水肿等行肾动脉造影的病例,动脉粥样硬化病因为主(占70.7%),介入治疗的比例和技术成功率升高(P<0.05),且介入治疗方式由单纯球囊扩张为主变为球囊预扩张后支架植入为主(P<0.05)。结论17年来肾动脉狭窄的病因学和临床特征及其介入治疗均发生了明显变化。

Objective To observe the changes of clinical characteristics and interventional methods of patients with renal artery stenosis in recent 17 years. Methods Comparing the clinical characteristics and interventional treatment of patients diagnosed renal artery stenosis by the means of renal angiography in recent 17 years. Results The numbers of renal artery stenosis were increasing year by year. the average ages before the year of 2000 was younger than that after 2000 （P 〈0. 05） and the main cause of renal artery stenosis was aorto-arteritis at that time, however, it turned to artheroseleroselerosis after the year of 2000. Same patients indicated renal angiography due to plash pulmonery edema, unstable angina on abnormal serum ereatinine. The interventional methods to renal artery stenosis shifted from balloon angioplasty only before the year of 2000 to stent implantation post-balloon dilatation after the year of 2000. The distal protective device was more used during the procedure. Conclusions The numbers of patients indicated renal angiography had been increasing in the two decades. The main causes of renal artery stenosis had been considered arthro -sclerosis instead of aorta-arteritis before. The methods of treatment to renal artery stenosis had been changed to renal stenting post-balloon angioplasty after the year of 2000.