经皮肾动脉支架置入术治疗肾动脉狭窄致难治性高血压病疗效观察

Clinical analysis of the efficacy of intervention treatment for atherosclerotic renal artery stenosis

目的观察动脉粥样硬化性肾动脉狭窄（ARAS）致难治性高血压经皮肾动脉支架置入术（PTRAS）前后患者的临床效果。方法2007年6月至2009年7月在北京华信医院住院治疗的20例难治性高血压患者，经肾动脉造影确诊为动脉粥样硬化性肾动脉狭窄，同时行。肾动脉支架置入术，观察介入治疗前后血压、服药数量及肾功能变化。结果手术成功率为100％，无手术并发症。收缩压由术前（176±15）mmHg降至（142±7）mmHg（1mmHg=0．133kPa），舒张压由（101±16）mmHg降至（90±7）mmHg（P〈0．01），口服降压药物由（3．3±0．6）片降至（1．5±0．8）片（P〈0．01），肌酐和尿素氮在手术前后无明显差异。结论PTRAS是目前治疗ARAS的有效方法，具有安全、简便的优点。

Objective To evaluate the clinical efficacy of percutaneous transluminal renal angioplasty and stenting（PTRAS） in 20 patients with atherosclerotic renal artery stenosis （ARAS）. Methods From June 2007 to July 2009, the clinical data of 20 patients diagnosed of atherosclerotic renal artery stenosis by angiography and treated with revascularization were analyzed. Results The immediate success rate of PTRAS was 100% without any complication. Before and after PTRAS, the systolic blood pressure was reduced from （ 176± 15 ） mm Hg to （ 142 ± 7 ） mm Hg（P 〉0.01 ）. The diastolic blood pressure was reduced from （101 ± 16）mm Hg to（90± 7）mm Hg（ P 〉 0. 01 ） ; the number of oral antihypertensive drugs was reduced from （ 3.3 ± 0. 6） to （ 1.5 ± 0. 8 ） （ P 〉 0.01 ）. There were no significant differences in creatinine and urea nitrogen. Conclusion PTRAS carries high success rate and appears to be an effective and safe treatment for ARAS.