肾动脉狭窄介入治疗分析

Analysis of Percutaneous Transluminal Renal Artery Angioplasty Treatment in Renal artery Stenosis

目的通过比较肾动脉狭窄介入治疗前后的相关因素的变化,评价肾动脉介入治疗对肾性高血压、肾功能不全等的影响。方法统计并分析65例单侧或双侧肾动脉狭窄患者共75支肾动脉支架术术前及术后的有关血压及肾功能相关指标的变化。结果75例肾动脉狭窄支架术成功率达100%。手术24 h后血压较术前显著下降,并在术后3月内保持稳定。术后(出院前)血肌酐水平、内生肌酐清除率及肾素水平明显下降。肾脏形态变化不大。术后24 hβ2微球蛋白较术前轻度升高,尿常规检查阳性者亦较术前增多。结论肾动脉狭窄支架术对患者的肾功能有保护作用。对血压的控制也具有重要临床意义。但术后短期内介入治疗可能仍有副作用。

Aim To estimate the influence of pereutaneous transluminal renal artery angioplasty （ PTBA ） in renal hypertension and renal failure by the related factor changes between pre- and post- PTRA. Methods The way of diagnosis of renal artery stenosis and its degrees is radionuelide angiography. The changes of the blood pressure, urea, serum ereafinine, β2 micro- globin, size of kidney, urine examination and renin in pre- and post- PTRA in the 65 patient with unilateral or double renal artery stenosis with totally 75 PTRA were analyzed. Results All of the 75 PTRA were successful. The blood pressure dropped after 24 hours since PTRA and keep steady at the following 3 months, Serum ereatinine, creatinine clearance rate, renin dropped after PTRA. Sizes of suffering kidney had no change. And the β2 micro- globins rised a bit after PTRA. Urine examinations had more positives than that of pre-PTRA. Conclusion PTRA can protect renal function, and it has clinic significance in treatraent of hypertension, But it might have side effect in the near future after PTRA.