动脉粥样硬化性肾动脉狭窄的诊疗进展
王亮,杨胜利,刘小慧
摘要(Abstract):
<正>动脉粥样硬化性肾动脉狭窄(atherosclerotic renal artery stenosis,ARAS)可导致缺血性肾病,从而激活肾素-血管紧张素Ⅱ-醛固酮系统(RAAS),引起高血压病、左心室肥厚和充血性心力衰竭。肾血管性高血压在轻度高血压人群中的发生率可能不足1%,但在急性高血压、重度高血压或难治性高血压中的发生率却可能高达[10%~40%1]。ARAS相关的难治性高血压和缺血性肾病甚至可导致严重的肾功能不全和充血性心力衰竭。肾动脉狭窄(renal artery
关键词(KeyWords): 动脉粥样硬化性肾动脉狭窄;经皮肾动脉介入治疗
基金项目(Foundation):
作者(Author): 王亮,杨胜利,刘小慧
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