老年高血压合并动脉粥样硬化性肾动脉狭窄患者的介入治疗

Intervention therapy for elderly hypertensive patients with atherosclerotic renal artery stenosis

目的探讨老年高血压合并动脉粥样硬化性肾动脉狭窄患者介入治疗的安全性和有效性。方法选择高血压合并动脉粥样硬化性肾动脉狭窄行血管腔内成形治疗的老年患者50例,术后随访12个月,观察介入治疗前后的血压、应用降压药物种类、肾功能变化以及肾动脉支架通畅情况。结果 50例患者共56支肾动脉均成功进行肾动脉支架置入术;与术前比较,患者术后6、12个月收缩压[(144.76±11.39)mm Hg,(143.73±9.84)mm Hg vs(167.88±22.54)mm Hg,1 mm Hg=0.133kPa]、舒张压[(77.78±7.54)mm Hg,(76.52±8.47)mm Hg vs(109.74±9.97)mm Hg]明显降低(P<0.05)。服用降压药物种类由术前(2.97±1.12)种减少为(1.75±0.34)种(P<0.05)。4例患者因出现肾动脉支架再狭窄再次行肾动脉成形术。结论血管腔内成形术治疗老年高血压合并动脉粥样硬化性肾动脉狭窄中期疗效安全、满意。

Objective To study the safety and efficency of intervention therapy for elderly hypertensive patients with atherosclerotic renal artery stenosis.Methods Fifity elderly hypertensive patients with atherosclerotic renal artery stenosis were followed up for 12 months,during which their blood pressure,types of hypotensor,renal function and renal artery stenting were recorded before and after intervention.Results The intervention therapy was successful in the 50patients（56branches of renal artery）.Their systolic and diastolic blood pressure were significantly lower6 and 12 months after intervention than before intervention（144.76±11.39 mm Hg and143.73±9.84 mm Hg vs 167.88±22.54 mm Hg,77.78±7.54 mm Hg and 76.52±8.47 mm Hg vs 109.74±9.97 mm Hg,P〈0.05）.The number of administered types of hypotensor was significantly less after intervention than before intervention（1.75±0.34 vs 2.97±1.12,P〈0.05）.Four patients underwent a secondary renal artery plasty due to stent restenosis.Conclusion Angioplasty is effective and safe for elderly hypertensive patients with atherosclerotic renal artery stenosis.