支架置入术治疗肾动脉狭窄的疗效分析.docVIP

支架置入术治疗肾动脉狭窄的疗效分析 　　DOI：10.3760/cma.j.issn.1671-0282.2013.11.015 　　作者单位：330006 南昌，江西省人民医院心内科，江西省心血管病研究所 　　通信作者：盛国太，Email：sgt1965@163.com 　　【摘要】目的 分析和观察肾动脉支架置入术治疗肾动脉狭窄的疗效性和安全性。方法 2003年1月至2012年6月，江西省人民医院50例单侧或双侧肾动脉狭窄≥70%的高血压患者，其中男性32例，女性18例，年龄21～78岁，（51.2±12.3）岁，均经股动脉或桡动脉途径行肾动脉支架置入术，并定期随访6个月，观察血压、降压药物和肾功能的动态变化。计量资料采用 t 检验。结果 肾动脉支架技术成功率为100%。50例患者中高血压治愈16例（32%）、改善30例（60%）、无效4例（8%）。与术前相比较，6月术后患者血压明显下降[收缩压（145.7±11.3）mmHg vs.（179.1±22.3）mmHg（1 mmHg=0.133 kPa），舒张压[（75.1±9.2）mmHg vs.（112.5±19.2）mmHg]，降压药物种类减少，血肌酐（sCr）下降[（138.2±20.3）μmol/L vs.（191.1±36.5）μmol/L]，差异具有统计学意义（均P0.05）。围手术期和随访期间，无严重并发症和死亡发生。结论 肾动脉支架置入术临床疗效肯定，手术成功率高，并具有一定的肾功能保护作用。 　　【关键词】高血压；肾动脉狭窄；支架术 　　Efficacy of percutaneous transluminal renal artery stenting in patients with renal artery stenosis TANG Yu，GUO Yu-zhi，SHENG Guo-tai，LUO Jun，YU Mao-sheng，WU Zhi-yong.Department of Cardiology，Jiangxi Provincial People’s Hospital，Nanchang 330006，China 　　Corresponding author： SHENG Guo-tai ，Email：sgt1965@163.com 　　【Abstract】Objective To explore the short term efficacy and safety of percutaneous transluminal renal artery stenting in patient with renal artery stenosis. Methods From January 2003 through June 2012， fifty hypertension patients with unilateral or bilateral renal artery stenosis≥70% were successfully treated by percutaneous translumminal renal angioplasty with stent（PTRAS）. There were 32 males and 18 females with an average age of （51.2±12.3） years ranged from 21～78 years. The blood pressure level， dosage of anti-hypertension drugs and serum creatinine （Scr） of patients were documented and analyzed before and after stenting. All patients were clinically followed up for 6 months after stenting. Continuous variables were analyzed by using t -test for comparison among patients.Results The technical success rate was 100%. Of them， 16 patients were cured， 30 patients improved and 4 patients ineffective. There were significant differences in blood pressure， sCr and dosage of anti-hypertension drugs betw