论文部分内容阅读
目的评估肾动脉支架术对高血压合并肾动脉狭窄患者血压的影响。方法对患有高血压的67例肾动脉明显狭窄(管腔内径减少≥70%)的患者行肾动脉支架植入术(PTRAS),术后行血压及血肌酐(SCr)的长期随访。结果患者67例植入77枚支架均获成功。所有患者均随访血压及肾功能,平均随访时间(18±6)月,随访患者的收缩压由(171±23)下降至(160±20)mmHg,P<0.05,舒张压由(95±14)下降至(85±13)mmHg,P<0.01;降压药物的种类显著减少[由(2.7±1.6)下降至(1.9±1.4)种,P<0.01]。术前肾功能正常者(SCr<130μmol/L)术后血压下降最为显著[收缩压由(176±33)下降至(159±26)mmHg,P<0.01,舒张压由(98±15)下降至(83±15)mmHg,P<0.01]。而术前肾功能受损者(130≤SCr≤350μmol/L)术后血压无明显改变。术后随访血肌酐及肾小球滤过率较术前无明显改变。结论肾动脉支架植入术有助于肾功能正常的高血压患者血压控制。
Objective To evaluate the effect of renal artery stenting on the blood pressure in hypertensive patients with renal artery stenosis. Methods Sixty-seven patients with hypertensive renal artery stenosis (≥70% lumen diameter reduction) underwent renal artery stenting (PTRAS). Postoperative long-term follow-up of blood pressure and serum creatinine (SCr) were performed. Results 67 patients were implanted in 77 cases were successful. All patients were followed up for blood pressure and renal function. The average follow-up time was (18 ± 6) months. The systolic blood pressure decreased from (171 ± 23) to (160 ± 20) mmHg at follow-up, P < ) Decreased to (85 ± 13) mmHg, P <0.01. The types of antihypertensive drugs decreased significantly from (2.7 ± 1.6) to (1.9 ± 1.4), P <0.01. The blood pressure decreased most preoperatively (SCr <130μmol / L) in patients with preoperative renal function (systolic blood pressure decreased from (176 ± 33) to (159 ± 26) mmHg, P <0.01, diastolic blood pressure decreased from (98 ± 15) To (83 ± 15) mmHg, P <0.01]. Preoperative renal dysfunction (130 ≤ SCr ≤ 350μmol / L) no significant change in postoperative blood pressure. Postoperative follow-up serum creatinine and glomerular filtration rate was no significant change than before surgery. Conclusion Renal artery stent implantation is helpful to the control of blood pressure in hypertensive patients with normal renal function.