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目的:探讨肾动脉狭窄的无创预测因素,为肾动脉狭窄提供针对性诊治方案。方法:收集我院于2006年1月～2009年12月因高血压行肾动脉造影患者94例的临床资料、实验室检查和影像学检查资料,并进行统计分析。结果:肾动脉造影证实为肾动脉狭窄患者48例(狭窄组)与无肾动脉狭窄的对照组(46例)相比血管紧张素Ⅱ(AngⅡ)水平显著升高(103.1±122.6pg/mlvs39.3±21.6pg/ml,P=0.028),多元回归分析显示AngⅡ水平升高与肾动脉狭窄密切相关(OR=5.667,95%CI1.254～25.606,P=0.024)。进一步对肾动脉彩超阴性的患者资料统计分析显示,彩超未发现肾动脉狭窄而肾动脉造影证实有肾动脉狭窄者血AngⅡ水平仍显著高于肾动脉造影未显示狭窄者(183.4±180.8pg/mlvs41.6±25.2pg/ml,P=0.014),多元回归分析显示,在彩超阴性的患者中,AngⅡ水平升高与肾动脉狭窄者密切相关(OR=14.667,95%CI1.161～185.235,P=0.038)。结论:血AngⅡ水平可以作为肾动脉狭窄的预测指标,特别是可以用于疑诊肾动脉狭窄而超声阴性患者是否行进一步有创检查的评估指标。
Objective: To investigate noninvasive predictors of renal artery stenosis and provide targeted diagnosis and treatment of renal artery stenosis. Methods: The clinical data, laboratory tests and imaging examination data of 94 patients with renal artery angiography who underwent hypertension in our hospital from January 2006 to December 2009 were collected and statistically analyzed. Results: Renal artery angiography showed that the level of angiotensin Ⅱ was significantly increased in 48 patients with stenosis (stenosis group) compared with 46 patients without stenosis of renal artery (103.1 ± 122.6 pg / ml vs 39). 3 ± 21.6 pg / ml, P = 0.028). Multiple regression analysis showed that elevated AngⅡ level was closely related to renal artery stenosis (OR = 5.667,95% CI1.254 ~ 25.606, P = 0.024). Further statistical analysis of patients with color Doppler ultrasound of renal artery showed that color Doppler ultrasound did not find renal artery stenosis and renal artery angiography confirmed renal artery stenosis blood AngⅡ level was still significantly higher than that of renal artery angiography did not show stenosis (183.4 ± 180.8pg / mlvs41 .6 ± 25.2pg / ml, P = 0.014). Multiple regression analysis showed that in patients with color Doppler ultrasound, elevated AngⅡ level was closely related to renal artery stenosis (OR = 14.667,95% CI1.161-185.235, P = 0.038). Conclusion: AngⅡ level can be used as a predictor of renal artery stenosis, especially for the evaluation of patients with suspected stenosis of renal artery and ultrasound-negative patients.