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动脉粥样硬化性肾动脉狭窄、肌纤维发育不良和大动脉炎是肾动脉狭窄的主要病因。对于粥样硬化性肾动脉狭窄的患者,普遍的共识是不论血运重建与否都必须接受规范的药物治疗。关于血运重建是否有益及哪些患者可以从血运重建中获益仍存在争议。虽然不鼓励对所有肾动脉狭窄的患者都积极地予以血运重建,但对合并有反复发作的原因不明的肺水肿、肾血流动力学显著恶化以及高血压难以控制的粥样硬化性肾动脉狭窄患者,经皮肾动脉介入治疗应该是更具有积极意义的。作者对无创及有创性检查在动脉粥样硬化性肾动脉狭窄中的应用作一综述。
Atherosclerotic renal artery stenosis, myofibrillar dysplasia and arteritis are the major causes of renal artery stenosis. For patients with atherosclerotic renal artery stenosis, there is a general consensus that whether revascularization or not must be regulated medication. Whether or not revascularization benefits and which patients benefit from revascularization remains controversial. Although it is discouraged that all patients with renal artery stenosis are actively revascularized, pulmonary edema with unexplained recurrent spasms, marked deterioration of renal hemodynamics, and atherosclerotic renal artery refractory to hypertension Narrow patients, percutaneous renal artery intervention should be more positive. The authors review the application of noninvasive and invasive examination in atherosclerotic renal artery stenosis.