肾动脉支架置入术对缺血性肾病患者血ET-1,AT-Ⅱ及肾功能的影响

Effects of Renal Artery Stentings on Sertun ET-1,AT-Ⅱ and Renal Function of Patients with Ischemic Renal Disease

目的评价肾动脉支架置入术对缺血性肾病患者血压及肾功能的影响及机制探讨。方法对11例经肾动脉造影确诊为单侧或双侧肾动脉狭窄(管腔内径减少≥70%)的患者行肾动脉支架置入术,比较术前、术后血压、血肌酐(Scr)及内皮素-1(ET-1)、血管紧张素-Ⅱ(AT-Ⅱ)的变化。结果11例患者置入支架13枚均获成功,术后6月患者的血压4例治愈,6例改善,1例无效,Scr较术前明显下降(P<0.05);ET-1、AT-Ⅱ自术后3月起即稳定在低水平,与术前比较有显著性差异(P<0.05,P<0.01)。结论肾动脉支架置入术有助于缺血性肾病患者的血压控制,改善肾功能;机制与降低血ET-1、AT-Ⅱ有关。

Objective To evaluate the effects of stent revascularization on blood pressure and renal function of patients with isehemie renal disease（IRD） and analyse the mechanism. Methods Pereutaneous transluminal renal angioplasty with stent （PTRAS） were performed on 11 cases with renal artery stenosis diagnosed by renal angiography. ALL patients were underwent 6 months clinical follow-up to observe the level of blood pressure, serum creatinine （Scr）, endothelin-1 and angiotensin-Ⅱ. Results 13 stents were successfully implanted for 11 eases. After 6 months, the blood pressure became normal without taking any antihypertensive medication in 4 cases and there were improvement in 6 cases. However, there was inefficient in one case. Scr signicantly decreased after 6 months （P〈0.05）; ET-1, AT-Ⅱ were stable at low levels after 3 months and there were significant difference compared with before operation （P〈0. 05, P〈0. 01）. Condusions PTRAS is helpful for the blood pressure control and the renal function improvement in IRD patients. The mechanism maybe relates to the decrease of serum ET-1 and AT-Ⅱ.