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其他题名Clinical Value of Renin-angiotensin System Evaluation in Percutaneous Transluminal Renal Angioplasty
金仲慧; 张龙; 张燕燕; 李选; 朱慧慈
关键词肾动脉成形术 肾素-血管紧张素系统 预后 高血压 Percutaneous transluminal renal angioplasty Renin-angiotensin system Prognosis High blood pressure
收录类别中国科技核心期刊 ; CSCD
文章类型Journal Article
摘要目的:探讨经皮腔内肾动脉成形( percutaneous transluminal renal angioplasty ,PTRA)术前肾素-血管紧张素系统( renin-angiotensin system ,RAS)检测的临床价值。方法采用回顾性队列研究的方法分析2009年10月~2013年10月76例我院PTRA的病历资料,以高血压危险等级下降为治疗有效的评价标准,评价术前血压分级、RAS水平、肾血流灌注情况、小肾图及肾动脉狭窄程度等指标对PTRA适应证选择和预后的价值。结果 RAS阳性患者发生高血压降级的可能(比值比, odd ratio,OR)是RAS阴性患者的3.927倍(χ2=4.354,P=0.037);与高血压一级相比,高血压二级患者发生高血压降级的可能是4.050倍(确切logistic回归法,P=0.089),高血压三级患者发生高血压降级的可能为12.424倍(确切logistic回归法, P=0.016)。其余血流灌注延迟、小肾图、肾动脉狭窄程度等指标在2组间差异均无显著性。结论 RAS检测在PTRA术中具有重要临床价值。不同级别的高血压降级比率明显不同,伴有三级和二级高血压的肾动脉狭窄PTRA术后预后较好。 Objective To discuss the clinical value of renin-angiotensin system ( RAS ) evaluation in percutaneous transluminal renal angioplasty ( PTRA) . Methods A retrospective cohort study was carried out to analyze 76 cases of medical records of PTRA operated from October 2009 to October 2013.We deemed the decrease of high blood-pressure (HBp) risk as effective for the operation, according to which we analyzed the prognostic factors among blood pressure , RAS, renal artery perfusion images , small renogram, and angiography of renal artery . Results There was a 3.927 times of possibility of decreasing grade of HBp at RAS positive patients than that at negative patients (χ2 =4.354, P=0.037).In contrast to grade Ⅰof HBp, there was a 4.050 times of possibility of decreasing grade at grade Ⅱ of HBp (exact logistic regression method, P=0.089), and a 12.424 times at grade Ⅲ(exact logistic regression method, P=0.016).There was no significant difference in other factors such as renal artery delay perfusion , small renogram, or stenosis level of renal artery . Conclusions RAS has important clinical value in PTRA operation .There are different outcomes between different high pressure grades .Renal stenosis complicated with grade III and II high blood pressure has a better prognosis after PTRA .
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2.北京大学第三医院 介入血管外科,北京,100191
Recommended Citation
GB/T 7714
金仲慧,张龙,张燕燕,等. 肾素-血管紧张素检测在经皮腔内肾动脉成形术中的临床价值[J]. 中国微创外科杂志,2014(11):1023-1027.
APA 金仲慧,张龙,张燕燕,李选,&朱慧慈.(2014).肾素-血管紧张素检测在经皮腔内肾动脉成形术中的临床价值.中国微创外科杂志(11),1023-1027.
MLA 金仲慧,et al."肾素-血管紧张素检测在经皮腔内肾动脉成形术中的临床价值".中国微创外科杂志 .11(2014):1023-1027.
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