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目的评价经皮血管成形术(PTA)治疗肾动脉纤维肌性发育不良(FMD)的疗效及安全性。方法连续入选我院近6年来因严重高血压入院,经肾动脉造影确诊为肾动脉FMD并行PTA的患者。回顾性分析其临床特点,并随访血压、降压药使用情况和PTA治疗效果。结果共入选20例患者,年龄13～47岁(平均24.5±7.8岁),其中女性12例(60.0%)。肾动脉造影显示共23条肾动脉受累,其中21条肾动脉直径狭窄>60%的患者行肾动脉成形术,包括单纯球囊扩张17例(80.9%),球囊扩张加支架置入4例(19.1%),技术成功率为95.2%(20/21)。经过1～6年随访,改为肾动脉逐年累积再狭窄发生率为15.0%,20.7%,26.3%,33.7%,33.7%,33.7%。结论 PTA治疗肾动脉FMD安全有效。
Objective To evaluate the efficacy and safety of percutaneous transluminal angioplasty (PTA) in the treatment of renal muscular dysplasia (FMD). Methods The patients admitted to our hospital for severe hypertension during the past 6 years were diagnosed as renal artery FMD with PTA by renal artery angiography. Retrospective analysis of its clinical features, and follow-up of blood pressure, antihypertensive drug use and PTA treatment. Results A total of 20 patients were enrolled, aged from 13 to 47 years (average 24.5 ± 7.8 years), including 12 females (60.0%). Renal angiography showed that a total of 23 renal arteries were involved. Among them, 21 patients with renal artery diameter stenosis> 60% underwent renal artery angioplasty, including 17 cases (80.9%) of simple balloon dilation, 4 cases of balloon dilatation plus stent (19.1%), the technical success rate was 95.2% (20/21). After 1 to 6 years of follow-up, the yearly cumulative restenosis rate of renal artery was 15.0%, 20.7%, 26.3%, 33.7%, 33.7% and 33.7%. Conclusion PTA treatment of renal artery FMD safe and effective.