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目的观察动脉粥样硬化性肾动脉狭窄(ARAS)患者经皮肾动脉支架置入术(PTRAS)后肾功能及血压的变化,探讨PTRAS前肾功能水平对预后的影响。方法23例ARAS患者以PTRAS前肾小球滤过率(GFR)≥50ml.min-1.1.73mm-2和<50ml.min-1.1.73mm-2为标准,分为A组(14例)和B组(9例),比较总体及各组患者PTRAS后血压和肾功能的变化。结果PTRAS后23例患者总体收缩压下降19mmHg(1mmHg=0.133kPa,P=0.000),舒张压下降6mmHg(P=0.051)。血清肌酐(Cr)升高4.4%(P=0.594),GFR下降4.4%(P=0.462)。其中A组血压下降26/8mmHg(P=0.000,P=0.033),Cr升高21.8%(P=0.137),GFR下降12.9%(P=0.066);B组血压下降8/1mmHg(P=0.292,P=0.773),Cr下降12.6%(P=0.126),GFR升高16.8%(P=0.090)。结论PTRAS能够明显改善ARAS患者血压;PTRAS后肾功能总体改善不明显。
Objective To observe the changes of renal function and blood pressure after percutaneous renal artery stenting (PTRAS) in patients with atherosclerotic renal artery stenosis (ARAS) and to explore the effect of PTRAS anterior renal function on prognosis. Methods Twenty-three patients with ARAS were divided into group A (n = 14) and standard PTRAS glomerular filtration rate (GFR) ≥50ml.min-1.1.73mm-2 and <50ml.min-1.1.73mm- Group B (n = 9). The changes of blood pressure and renal function after PTRAS were compared between the two groups. Results The overall systolic blood pressure decreased by 19 mmHg (1 mmHg = 0.133 kPa, P = 0.000) and diastolic blood pressure decreased by 6 mmHg in 23 patients after PTRAS (P = 0.051). Serum creatinine (Cr) increased 4.4% (P = 0.594), GFR decreased 4.4% (P = 0.462). The blood pressure decreased 26 / 8mmHg in group A (P = 0.000, P = 0.033), 21.8% in Cr (P = 0.137) and 12.9% in GFR , P = 0.773), Cr decreased 12.6% (P = 0.126) and GFR increased 16.8% (P = 0.090). Conclusion PTRAS can obviously improve the blood pressure of patients with ARAS. The overall improvement of renal function after PTRAS is not obvious.