中国临床医学影像杂志
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经皮肾动脉支架成形术在移植肾和动脉粥样硬化性肾动脉狭窄中的应用价值及比较
吕朝阳,高  堃,黄  强,王剑锋
首都医科大学附属北京朝阳医院,北京  100020
Application and comparison of percutaneous transluminal renal stent in transplant renal artery stenosis and atherosclerotic renal artery stenosis
LV Chao-yang, GAO Kun, HUANG Qiang, WANG Jian-feng
Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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摘要 目的:探讨经皮肾动脉成形支架植入术(Percutaneous transluminal renal stent,PTRS)治疗移植肾肾动脉狭窄(Transplant renal artery stenosis,TRAS)与动脉粥样硬化性肾动脉狭窄(Atherosclerotic renal artery stenosis,ARAS)的疗效差异。方法:回顾性分析我院2010—2017年TRAS和ARAS的患者各30例,对PTRS治疗前后的肌酐、收缩压以及术后再次狭窄的情况进行统计学分析,比较两组治疗的疗效差异。结果:对于TRAS组,肌酐、收缩压由术前的(204.1±58.3) mmol/L、(167±18) mmHg(1 mmHg=0.133 kPa),术后3月降为(119.8±43.1) mmol/L(P<0.05)、(136±12) mmHg(P<0.05);术后1年降为(116.1±27.6) mmol/L(P<0.05)、(137±9) mmHg(P<0.05);术后3年降为(118.6±30.2) mmol/L(P<0.05)、(133±8) mmHg(P<0.05)。对于ARAS组,肌酐、收缩压由术前的(101.2±11.3) mmol/L、(165±20) mmHg,术后3月为(100.3±21.2) mmol/L(P>0.05)、(142±10) mmHg(P<0.05);术后1年为(81.3±23.4) mmol/L(P>0.05)、(141±17) mmHg(P<0.05);术后3年为(97.0±18.1) mmol/L(P>0.05)、(144±20) mmHg(P<0.05)。在术后再狭窄方面,术后6月,TRAS组和ARAS组支架再狭窄的比例分别为13.3%、6.7%(P<0.05);术后3年,TRAS组和ARAS组支架再狭窄比例分别为14.3%、25.0%(P<0.05)。结论:PTRS对于ARAS患者和TRAS患者均有良好的临床疗效,相较于ARAS患者,PTRS在TRAS患者中有着相对较低的再狭窄率。
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吕朝阳
高 堃
黄 强
王剑锋
关键词 肾移植肾动脉梗阻放射学介入性    
Abstract:Objective: To evaluate and compare the value of percutaneous transluminal renal stent(PTRS) in the treatment of transplant renal artery stenosis(TRAS) and atherosclerotic renal artery stenosis(ARAS). Methods: Thirty cases selected from TRAS and ARAS in 2010—2017 in our hospital, divided into group TRAS and group ARAS. Statistical analysis was performed on creatinine, systolic blood pressure, and postoperative restenosis before and after stent implantation. The systolic blood pressure and postoperative restenosis were compared between two groups and the restenosis of the two groups was followed up. Results: For group TRAS, creatinine and systolic blood pressure were improved postoperatively, creatinine and systolic blood pressure were (204.1±58.3) mmol/L and (167±18) mmHg(1 mmHg=0.133 kPa) before operation, and decreased to (119.8±43.1) mmol/L and(136±12) mmHg(P<0.05) after 3 months, decreased to (116.1±27.6) mmol/L(P<0.05) and (137±9) mmHg(P<0.05) after 1 year, decreased to (118.6±30.2) mmol/L(P<0.05) and (133±8) mmHg(P<0.05) after 3 years. The statistically difference was significantly performed between preoperative and postoperative results(P<0.05). For group ARAS, creatinine and systolic blood pressure were improved postoperative, creatinine and systolic blood pressure were (101.2±11.3) mmol/L and (165±20) mmHg before operation, and decreased to (100.3±21.2) mmol/L(P>0.05)  and (142±10) mmHg(P<0.05) after 3 months, decreased to (81.3±23.4) mmol/L(P>0.05) and (141±17) mmHg(P<0.05) after 1 year, decreased to (97.0±18.1) mmol/L(P>0.05) and (144±20) mmHg(P<0.05) after 3 years. For the restenosis after the operation, the proportions of stent restenosis in group TRAS and group ARAS were 13.3% and 6.7% respectively after 6 months. The proportions of moderate and severe renal artery stenosis in group TRAS and group ARAS were 14.3% and 25.0% respectively after 3 years. The statistically difference was significantly performed between preoperative and postoperative results(P<0.05). Conclusion: PTRS has good clinical efficacy for ARAS patients and TRAS patients. Compared with ARAS patients, PTRS has relatively lower restenosis rate in TRAS patients.
    
PACS:  R699.2  
  R815  
基金资助:Kidney transplantation; Renal artery obstruction; Radiology, interventional
通讯作者: 王剑锋,首都医科大学附属北京朝阳医院,100020。E-mail:jianfeng_wang@126.com   
作者简介: 吕朝阳(1992-),男,山东威海人,住院医师。E-mail:lzhy910@163.com
引用本文:   
吕朝阳,高 堃,黄 强,王剑锋. 经皮肾动脉支架成形术在移植肾和动脉粥样硬化性肾动脉狭窄中的应用价值及比较[J]. 中国临床医学影像杂志, 2019, 30(6): 425-428.
LV Chao-yang, GAO Kun, HUANG Qiang, WANG Jian-feng. Application and comparison of percutaneous transluminal renal stent in transplant renal artery stenosis and atherosclerotic renal artery stenosis. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(6): 425-428.
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http://www.jccmi.com.cn/CN/10.12117/jccmi.2019.06.012     或     http://www.jccmi.com.cn/CN/Y2019/V30/I6/425
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