支架治疗动脉硬化性肾动脉狭窄对肾功能影响的前瞻性研究

Prospective study on effect of stent placement in patients with arteriosclerotic renal artery stenosis on renal insufficiency

目的:探讨肾动脉支架置入术,对肾动脉狭窄导致缺血性肾病患者的肾功能影响。方法:2008年1月至2010年1月,对肾动脉狭窄合并有肾功能不全的患者,采用肾动脉支架进行血管腔内治疗。术后1,3,6及12个月定期复查血清肌酐水平。结果:共入选26例患者进行了肾动脉支架治疗,男性14例,女性12例,平均年龄(62±14)岁,术前肾血清肌酐水平为(151.58±11.86)umol/L,术后1个月血肌酐水平为(149.96±16.39)umol/L,与术前差异无统计学意义(P=0.551)。术后3,6及12个月肌酐分别为〔(140.38±27.07)umol/L,P=0.02〕,〔(137.15±30.73)umol/L,P=0.005〕,〔(135.38±33.37)umol/L,P=0.005〕,均低于术前水平,差异具有统计学意义。结论:肾动脉腔内支架成形术,可改善肾动脉狭窄患者的肾功能。

Objective：To explore the of endovascular treatment with stents of patients with stenosis of renal artery on improvement of renal dysfunction. Methods： Between January, 2008 and January, 2011, pa- tients with renal artery stenosis and renal dysfunction were randomly selected for stenting of stenostie renal arter- y. Levels of serum creatinine was examined before procedure and during follow-up at 1, 3, 6, 12 months. Re- sults： Twenty six patients underwent stent placement including 14 male and 12 females, with average age of （62±14）years. Level of serum creatinine was （151.58±11.86） umol/L before treatment. All patients fol- lowed for one years, with circulation level of creatitine of （ 149. 96±16. 39 ） umol/L, （ 140. 38±27.07 ） umoL/L,P =0. 02） 3, [ （ 137. 15±30. 73 ） umol/L,P =0. 0053, [ （ 135.38±33.37） umol/L,P =0. 0053 at 1, 3, 6, 12 months. Level of serum ereatinine at 3, 6,12 months was significantly lower than that before proce- dure Conclusion： Endovascular treatment of stenting of stenotic renal artery could imorove the renal function ^