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目的 探讨经皮腔内肾动脉成形术 (PTRA)和肾动脉支架植入术 (STENT)治疗肾血管性高血压(RVH)的疗效及影响因素。方法 对 2 8例不同病因 (大动脉炎 1 0例 ,动脉粥样硬化 1 2例 ,肾动脉纤维肌性发育不良 6例 )致肾动脉狭窄患者行PTRA和植入支架。术后造影观察即时技术成功参数 ,复查血压 ,血清肌酐水平 ,并对其中 2 5例进行了随访 ,随访率 89 3% ,随访时间 0 8～ 7 1年 (3 8± 1 2 )。结果 即时技术成功率为 1 0 0 %(2 8/ 2 8) ,术后 2 8例高血压都得到明显改善 (1 0 0 % ) ,其中 1 8例 (6 5 % )降至正常 ,1 0例 (35 % )明显改善 ,1 9例肾功能得到改善 ,无严重并发症发生。结论 PTRA和肾动脉支架植入治疗RVH疗效良好 ,是一种安全有效的治疗方法 ,可作为RVH患者肾血管重建的首选方法
Objective To investigate the efficacy and influential factors of percutaneous transluminal renal artery angioplasty (PTRA) and renal artery stenting (STENT) in the treatment of renovascular hypertension. Methods PTRA and stent were implanted in 28 patients with renal artery stenosis who had different etiologies (10 cases of arteritis, 12 cases of atherosclerosis and 6 cases of renal muscular dysplasia). Postoperative angiography was used to observe the immediate technical success parameters, blood pressure and serum creatinine were reviewed. Twenty-five of them were followed up for 89.3% of follow-up visits. The follow-up time ranged from 38 to 71 years (38 ± 12). Results The immediate technical success rate was 100% (28/28). Significant improvement was found in 28 postoperative hypertensives (100%), of which 18 (65%) decreased to normal and 1 0 cases (35%) improved significantly, 19 cases of renal function improved without serious complications. Conclusion PTRA and renal artery stent implantation in the treatment of RVH is a safe and effective treatment and can be used as the preferred method of renal revascularization in patients with RVH