肌纤维发育不良型肾动脉狭窄腔内治疗临床分析

Clinical analysis of endovascular treatment of renal artery stenosis resulting from fibromuscular dysplasia

目的探讨肌纤维发育不良型肾动脉狭窄的腔内治疗方法。方法肌纤维发育不良肾动脉狭窄患者12例（均合并2～3级高血压或难治性高血压），行经皮肾动脉成形术治疗，术后随访观察患者血压、肾功能、术后再狭窄等相关指标，并记录患者疾病转归。结果失访1例，11例术后随访8～63个月，术后血压（（131±9）／（82±8）mmHg）较术前（（198±15）／（125±25）mmHg）明显下降（P〈0.01）；彩色多普勒超声检查显示术后发生再狭窄2例。结论肌纤维发育不良致肾动脉狭窄主要表现为难治性高血压或恶性高血压，腔内治疗方式应首选球囊扩张成形术。

Objective To investigate the endovascular treatment of renal artery stenosis resulting from fibromuscular dysplasia. Methods Twelve patients with fibromuscular dysplasia were complicated with hypertension in level 2 to 3 or refractory hypertension. All the patients underwent pereutaneous transluminal balloon angioplasty, and were observed the blood pressure, renal function and restenosis rate, and the outcomes were recorded. Results Eleven patients were followed up for 8 to 63 months and one patient was lost. The blood pressure decreased from （198± 15）/（125 ± 25） mm Hg before operation to （131±9）/（82±8）mm Hg after operation （P〈0.01）. Ultrasonographyshowed restenosisin only 2 patients. Conclusions Renal artery stenosis resulting from fibromuscular dysplasia mainly presents refractory hypertension or malignant hypertension, and balloon angioplasty is the first choice of endovascular treatment.