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目的探讨动脉粥样硬化性肾动脉狭窄(ARAS)患者的临床特点,评价介入治疗和单纯药物治疗对肾功能预后的影响。方法分析本院经肾动脉造影确诊的ARAS患者132例的临床资料。88例单侧ARAS按年龄≤70岁和>70岁分组及按基础GFR≥60 ml／min和GFIR< 60 ml／min分组,比较介入治疗和药物治疗对GFR的影响。44例双侧ARAS按行双侧、单侧、非介入治疗分组,比较3组差异。结果单侧ARAS、年龄≤70岁者,介入治疗1年后GFR变化值优于药物治疗组(P<0．05);基础GFR≥60 ml／min者,介入治疗1年后GFR变化值优于药物治疗组(P<0．05);年龄>70岁,GFR<60 ml／min者,介入治疗与药物治疗相比,GFR变化值无显著性差异。双侧ARAS者双侧介入治疗GFR变化值优于单侧介入,单侧介入优于非介入治疗组。Logistic回归分析示基础GFR≥60 ml／min,进行介入治疗的单侧AKAS者,肾功能(GFR)的预后较好。结论单侧ARAS年龄≤70岁,介入治疗前GFR≥60 ml／min者,介入治疗后肾功能 (GFR)预后较好;年龄大于70岁的患者,介入前应仔细评估,慎重选择介入治疗。
Objective To investigate the clinical features of patients with atherosclerotic renal artery stenosis (ARAS) and to evaluate the effect of interventional therapy and simple drug therapy on the prognosis of renal function. Methods The clinical data of 132 ARAS patients diagnosed by renal artery angiography in our hospital were analyzed. Eighty-eight unilateral ARAS were grouped according to age ≤70 years and> 70 years and grouped by basal GFR ≥60 ml / min and GFIR <60 ml / min. The effects of interventional therapy and drug therapy on GFR were compared. Forty-four patients with bilateral ARAS were divided into three groups according to bilateral, unilateral and non-interventional therapy. Results The changes of GFR in patients with unilateral ARAS and age ≤70 years after interventional treatment were better than those in the drug treatment group (P <0.05), and the GFR≥60 ml / min after interventional therapy In the drug treatment group (P <0.05), there was no significant difference in GFR between the interventional group and the drug group when they were over 70 years old and GFR <60 ml / min. Bilateral ARAS bilateral interventional treatment GFR better than unilateral intervention, unilateral intervention is better than non-interventional therapy group. Logistic regression analysis showed that the basis of GFR ≥ 60 ml / min, for the interventional treatment of unilateral AKAS, renal function (GFR) prognosis is good. Conclusion The unilateral ARAS age ≤70 years, before interventional therapy GFR ≥ 60 ml / min, after interventional treatment, the prognosis of renal function (GFR) is better; patients older than 70 years of age, should be carefully evaluated before intervention, careful choice of intervention.