粥样硬化性肾动脉狭窄与颅内-外动脉狭窄的关系

The relationship between intra-or extra-cranial artery stenosis and atherosclerotic renal artery stenosis

目的探讨肾动脉粥样硬化性狭窄(ARAS)与颅内-外动脉狭窄的关系。方法对304例疑为颅内-外动脉狭窄的患者行颅内-外动脉造影,同时作双侧肾动脉造影,了解颅内-外动脉和ARAS情况,对临床资料和ARAS的关系进行统计分析。结果304例患者中颅内-外动脉狭窄186例,ARAS90例(患病率29.6%)。186例颅内-外动脉狭窄患者合并ARAS77例,罹患率41.4%(77/186)。单纯ARAS患者13例,患病率11.0%(13/118)。ARAS在颅内-外动脉狭窄病变组中的罹患率明显高于无颅内-外血管病变组,两组间差异具有统计学意义(P<0.05)。在颅内-外动脉狭窄组中,中-重度或多支颅内-外动脉狭窄者ARAS发病率高。结论对有颅内-外动脉狭窄病变的患者造影后,应常规行肾动脉造影,以便早期发现ARAS。

Objective To investigate the relationship between intra- or extra-cranial artery stenosis and atheroselerotic renal artery stenosis （ARAS）. Methods Both selective intra- and extra-cranial angiography and bilateral renal angiography were performed in 304 patients with suspected intra- or extracranial artery stenosis in order to estimate the situation of the arterial stenosis. The results and the clinical data were compared and analyzed. Results Of 304 patients, intra- and/or extra-cranial arteriosclerotic stenosis was found in 186 and ARAS was revealed in 90 with an incidence of 29.6% （90/304）. Among 186 patients with intra- and/or extra-cranial arteriosclerotic stenosis, ARAS was accompanied in 77, with an incidence of 41.4% （77/186）. Of 118 patients with no intra- or extra-cranial arteriosclerotic stenosis, A RAS was found in 13 （11.0%, 13/118）. The frequency of ARAS in patients with intra- and/or extra-crania] arteriosclerotic stenosis was significantly higher than that in patients with no intra- and/or extra-cranial arteriosclerotic stenosis （P 〈 0.05）. The incidence of ARAS was unusually higher in patients with muhiple and moderate-severe intra- and/or extra-cranial arteriosclerotic stenosis. Conclusion Renal angiography should be routinely performed in patients with intra- or extra-cranial arteriosclerotic stenosis so as to be able to make an early detection of atherosclerotic renal artery stenosis.