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目的探讨动脉粥样硬化患者中肾动脉狭窄(ARAS)的患病率及其危险因素。方法2002年10月-2003年11月,以存在冠心病、脑血管病和(或)下肢血管血栓栓塞性疾病的患者作为动脉粥样硬化人群的选择标准,对这些患者行肾动脉造影,同时对比分析ARAS患者与无ARAS的动脉粥样硬化患者的临床特点。结果218例动脉粥样硬化性疾病患者中,24.3%存在ARAS。冠心病、脑血管病、下肢血管血栓栓塞性疾病患者中,ARAS的检出率分别为27.9%、30.0%和40.0%。ARAS的患病率有随年龄增加的趋势。66.0%的ARAS患者没有典型的症状,为造影过程中的“意外诊断”。同无ARAS的患者相比,这些患者合并颈动脉狭窄的比例较高(71.4%比35.9%,P<0.01)。结论ARAS在动脉粥样硬化性疾病人群中的患病率为24.3%。ARAS在下肢血管血栓栓塞性疾病的人群中检出率最高,应加强在动脉粥样硬化人群中,特别是周围血管病伴颈动脉狭窄的人群中对ARAS的筛查。
Objective To investigate the prevalence and risk factors of renal artery stenosis (ARAS) in patients with atherosclerosis. Methods From October 2002 to November 2003, patients with coronary heart disease, cerebrovascular disease and / or lower extremity vascular thromboembolic disease were selected as the criteria of atherosclerosis. Renal angiography was performed on these patients at the same time. The clinical features of patients with ARAS and atherosclerosis without ARAS were analyzed. Results Among 218 patients with atherosclerotic disease, 24.3% had ARAS. In patients with coronary heart disease, cerebrovascular disease and lower extremity vascular thromboembolic disease, the detection rates of ARAS were 27.9%, 30.0% and 40.0% respectively. The prevalence of ARAS tends to increase with age. 66.0% of patients without ARAS had typical symptoms and were “unexpectedly diagnosed” during imaging. Compared with patients without ARAS, these patients had a higher proportion of carotid stenosis (71.4% vs 35.9%, P <0.01). Conclusions The prevalence of ARAS in people with atherosclerotic disease is 24.3%. ARAS has the highest detection rate in people with lower extremity vascular thromboembolic disease and should be used to screen for ARAS in people with atherosclerosis, especially those with peripheral vascular disease and carotid artery stenosis.