经皮血管成形术治疗肌纤维发育不良型肾动脉狭窄的临床疗效

Clinical efficacy of percutaneous transluminal angioplasty in treatment of renal artery stenosis resulting from fibromuscular dysplasia

目的评价经皮血管腔内血管成形术(PTA)治疗肾动脉肌纤维性发育不良的疗效及安全性。方法选择肌纤维发育不良型肾动脉狭窄患者32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、药物治疗种类、术后再狭窄、生存率和并发症等。结果 PTA技术成功率93.94%(31/33)。术前、术后收缩压分别为(189.6±26.0)mmHg、(136.6±8.0)mmHg(t=9.117,P<0.001),舒张压分别为(121.6±21.7)mmHg、(81.1±11.5)mmHg(t=7.745,P<0.001)。无肾动脉破裂、夹层、分支堵塞及血栓形成等相关并发症和术后不良事件发生。术后随访时间5~100个月,平均(40.4±26.1)个月,患者生存率100%(32/32)。结论经皮血管成形术治疗肌纤维发育不良肾动脉狭窄安全、有效。

Objective To investigate the efficacy and safty of percutaneous transluminal angioplasty （PTA） of renal artery stenosis resulting from fibromuscular dysplasia. Methods A total of 32 patients with fibromuscular dysplasia complicated with hypertension in level 2 to 3 or refractory hypertension were enrolled, who underwent PTA. The blood pressure, types of medication, restenosis, survival rates and complications were observed after treatment. Results Technical success rate of PTA was 93.94% （31/33）. The blood pressure decreased from （189.6±26.0）mmHg/（121.6±21.7）mmHg before operation to （136.6±8.0）mmHg/（81.1±11.5）mmHg after operation （t=9.117, 7.745, both P〈0.001）. No renal artery rupture, interlayer, branch blockage, thrombosis and other related complications and postoperative adverse events occurred. All patients were followed up for 5 months to 100 months, with an average of （40.4±26.1） months. Survival rate was 100% （32/32）. Conclusion PTA is safe and effective for treating renal artery stenosis from fibromuscular dysplasia.