血清肌酐异常病人肾动脉介入治疗的疗效及安全性Efficacy and safety of renal artery intervention in patients with abnormal serum creatitine
倪钧,沈卫峰,张瑞岩,张奇,张宪,郑爱芳
摘要(Abstract):
目的 评价血清肌酐异常患者肾动脉介入治疗的疗效及安全性。方法 连续 91例经双侧肾动脉造影证实有显著肾动脉狭窄 (内径减少 >5 0 % )的病人接受肾动脉支架术治疗 ,包括肌酐异常 (>110 μmol L) 31例 (甲组 )及肌酐正常 6 0例 (乙组 )。记录 2组手术成功率和并发症 ,并测定各例患者术后 12h及术后 3个月血清肌酐值。比较 2组临床随访结果。结果 甲、乙 2组病人肾动脉支架术成功率分别为 97 0 %和 10 0 0 % (P >0 0 5 )。平均随访 (15± 7)个月 ,随访期内甲组术后再入院及肾功能衰竭发生率较乙组明显升高 (2 6 9%比 7 3% ,2 3 1%比 1 8% ,P <0 0 1)。而两组间心绞痛复发及血压改善差异无显著性。结论 术前肌酐异常的肾动脉狭窄患者介入术后预后不良。
关键词(KeyWords): 肾动脉狭窄;血清肌酐;介入治疗
基金项目(Foundation):
作者(Author): 倪钧,沈卫峰,张瑞岩,张奇,张宪,郑爱芳
参考文献(References):
- 1KhoslaS ,KunjummenB ,MandaR ,etal.Prevalenceofrenalarterystenosisrequiringrevascularizationinpatientsinitiallyreferredforcoronaryangiography.CatheterCardiovascInterv,2003,58:400403.
- 2PerkoviV ,ThomsonKR ,BeckerGJ,etal.Factorsaffectingoutcomeafterpercutaneousrenalarterystentinsertion.JNephrol,2002,15:649654.
- 3RundbachJH ,SacksD ,KentKC ,etal.Guidelinesforthereportingofrenalarteryrevascularizationinclinicaltrials.Circulation,2002,106:15721585.
- 4邢惠莉,沈卫峰,张奇,等.冠心病患者的肾动脉狭窄及介入治疗.介入放射学杂志,2002,11:266268.
- 5SofianRD ,TextorSC .Renal arterystenosis.NEnglJMed,2001,344:431442.
- 6WrightJR ,ShurrabAE ,CheungC ,etal.Aprospectivestudyofthedeterminantsofrenalfunctionaloutcomesandmortalityinartheroscleroticrenovasculardisease.AmJKidneyDis,2002,39:11531161.
- 7UzuT ,TakejiM ,YamadaN ,etal.Prevalenceandoutcomeofrenalarterystenosisinatheroscleroticpatientswithrenaldysfunction.HypertensRes,2002,25:537542.
- 8RamosF ,KotliarC ,AlvarezD ,etal.RenalfunctionandoutcomeofPTRAandstentingforatheroscleroticrenalarterystenosis.KidneyInt,2003,63:276282.