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目的评价肾功能状况对动脉粥样硬化性肾动脉狭窄性高血压患者行肾动脉支架植入术后血压控制的影响。方法 41例动脉粥样硬化性肾动脉狭窄性高血压患者入选本研究。根据术前肾功能状况将患者分为肾功能正常组(19例,eGFR≥60mL/min)与肾功能异常组(22例,eGFR<60mL/min),比较两组患者支架植入术前及术后随访6个月时血压变化及两组患者术后6个月降压的幅度。结果 41例肾动脉狭窄患者(44处病变)均成功进行了经皮肾动脉支架植入术,无严重并发症发生。两组患者术后6个月收缩压和舒张压均有显著性下降(P<0.01);与肾功能异常组比较,肾功能正常组术后6个月收缩压的降压幅度[(24.5±8.6)mmHgvs(17.3±11.3)mmHg,P<0.05]及舒张压的降压幅度[(15.5±7.5)mmHgvs(10.5±6.4)mmHg,P<0.05]均有显著性差异。结论肾功能无明显受损的患者早期行支架植入术,更易控制动脉粥样硬化性肾动脉狭窄引起的高血压。
Objective To evaluate the effect of renal function on blood pressure control in patients with atherosclerotic renal artery stenosis after renal artery stenting. Methods 41 patients with atherosclerotic renal artery stenosis were enrolled in this study. According to preoperative renal function, patients were divided into normal renal function group (19 cases, eGFR≥60mL / min) and renal dysfunction group (22 cases, eGFR <60mL / min) After 6 months of follow-up of blood pressure changes and two groups of patients after 6 months of antihypertensive range. Results 41 cases of renal artery stenosis (44 lesions) were successfully percutaneous renal artery stenting, no serious complications. Systolic blood pressure and diastolic blood pressure were significantly decreased in both groups at 6 months after operation (P <0.01). Compared with renal dysfunction group, the systolic blood pressure depressing rate at 6 months after operation in normal renal function group was significantly lower than that in normal renal function group [(24.5 ± 8.6) mmHg vs (17.3 ± 11.3) mmHg, P <0.05] and diastolic blood pressure [(15.5 ± 7.5) mmHg vs (10.5 ± 6.4) mmHg, P <0.05]. Conclusions Patients with no significant renal dysfunction underwent early stent implantation, making it easier to control hypertension caused by atherosclerotic renal artery stenosis.