摘要
目的评估经皮血管成形术在治疗移植肾动脉狭窄（TRAs）导致的移植肾功能损害和（或）高血压中的效果。方法回顾性分析1998年7月至2007年1月经皮肾动脉造影明确诊断为移植肾动脉狭窄的16例患者的临床资料。在16例患者被确诊前先行多普勒超声检查，有13例被发现TRAS，3例阴性，假阴性率为18．75％。对16例TRAS患者均采取经皮血管成形术治疗。术后对患者进行了3年的随访，分别在术后1周、6个月、1年、2年和3年时评估肾功能和高血压改善状况。以平均动脉压较术前下降至少15％定义为高血压改善；以血清肌酐降低至少20％定义为移植肾功能改善。结果经皮血管成形术成功率100％，16例患者经治疗后均获临床治愈。术后1周、6个月、1年、2年和3年时，肾功能改善率分别为81．25％、68．75％、62．5％、56．25％和50％，高血压改善率分别为62．5％、75％、75％、56．25％和50％，所有患者服用降血压药物的种类和用量均减少。结论经皮血管成形术对TRAS导致的肾功能损害和高血压有明显的改善作用，是安全和有效的治疗方法。
Objective To evaluate the efficacy of percutaneous transluminal angioplasty （PTA） in the treatment of transplanted renal artery stenosis （TRAS）-induced renal dysfunction and hypertension. Methods Between July 1998 and January 2007, PTA was performed on 16 patients with RTAS. Color Doppler ultrasonography preceded the intra-arterial angiographic investigation, with false-negative results in 18. 75 % of patients. Sixteen cases of TRAS were examined at 1 st week, 6th month and 1 3 years after PTA. Hypertension improvement was defined as mean arterial pressure decrease of at least 15 % from the pre-PTA value. Graft function was evaluated by SCr levels, and the improvement was defined as a 20 % change. Results Angioplasty was technically feasible in 100 %. Sixteen patients with RTAS were cured clinically. During the follow-up period, graft function was improved in 81.25 0%, 68. 75 %00, 62. 5 %, 56. 25 %, 50 % of patients respectively at 1st week, 6th month and 1-3 years after PTA. The blood pressure was decreased in 62.5 %, 75 %, 75 %, 56. 25 %, 50 % of patients respectively, but no patient remained hypotensor medication free. Conclusion PTA improved renal dysfunction and hypertension induced by TRAS, and it is a safe and effective treatment for TRAS.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2010年第5期276-279,共4页
Chinese Journal of Organ Transplantation
关键词
肾移植
肾动脉梗阻
血管成形术
气囊
Kidney transplantation
Renal artery obstruction
Angioplasty, balloon
