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目的探讨肾静脉肾素活性,血浆内皮素(ET)、一氧化氮(NO)、钙素基因相关肽(CGRP)水平对肾动脉狭窄介入治疗疗效的预测价值。方法60例冠心病合并高血压患者经肾动脉造影,证实为肾动脉狭窄,予肾动脉支架植入术;测定所有病例介入治疗前后的肾静脉肾素活性和血浆ET、NO、CGRP水平。并对病人的血压进行2年随访。结果60例患者根据术前肾素水平分为肾素比值(RVRR)>1.5组和RVRR<1.5组。所有患者肾动脉狭窄侧肾静脉肾素活性高于对侧[(3.89±3.14)nmol/L/h和(2.01±1.93)nmol/L/h,P<0.05],介入治疗后患侧肾静脉肾素浓度明显下降,RVRR>1.5组低于RVRR<1.5组[(1.92±2.15)nmol/L/h和(2.42±0.56)nmol/L/h,P<0.05],血浆ET和NO水平与RVRR<1.5组相比有统计学差异(P<0.05),术后血压明显下降,血压有效率75.68%,与RVRR<1.5组比P<0.05。结论测定肾静脉肾素活性,血浆ET、NO的水平对肾动脉血管成形术近期疗效有预测价值。
Objective To investigate the predictive value of renal vein renin activity, plasma endothelin (ET), nitric oxide (NO) and calcitonin gene related peptide (CGRP) levels in interventional therapy of renal artery stenosis. Methods Sixty patients with coronary heart disease and hypertension were diagnosed as renal artery stenosis and renal artery stent implantation. The renal renin activity and plasma ET, NO and CGRP levels were measured before and after interventional therapy in all patients. The patient’s blood pressure was followed up for 2 years. Results Sixty patients were divided into three groups based on preoperative renin: RVRR> 1.5 and RVRR <1.5. The renal vein renin activity was significantly higher in all patients with renal artery stenosis than in the contralateral side (3.89 ± 3.14 nmol / L / h and 2.01 ± 1.93 nmol / L / h, P <0.05) The levels of ET and NO in RVRR> 1.5 group were significantly lower than those in RVRR group <1.5 [(1.92 ± 2.15) nmol / L / h and (2.42 ± 0.56) nmol / L / (P <0.05). The postoperative blood pressure decreased significantly, the effective rate of blood pressure was 75.68%, compared with that of RVRR <1.5 (P <0.05). Conclusion The determination of renal vein renin activity, plasma ET, NO levels of renal artery angioplasty short-term efficacy of predictive value.