目的 探讨经皮腔内肾动脉支架置入术(PTRAS)治疗动脉粥样硬化性肾动脉狭窄(ARAS)对肾功能的影响.方法 经肾动脉造影确诊的ARAS并施行PTRAS患者50例,术后随访3～48(16.3±14.8)个月,回顾性分析PTRAS后患者血清肌酐和再狭窄发生率.结果 50例PTRAS全部成功.与PTRAS前比较,20例(40％)症状改善和26例(52％)症状稳定患者血清肌酐水平明显下降[(151.47±54.86)μmol/L vs (182.50±68.87) μmol/L,P＜0.01;(95.56±12.87)μmol/L vs (101.37±15.53)μmol/L,P＜0.05],4例(8％)症状恶化患者血清肌酐水平明显升高(P＜0.05).随访期间再狭窄6例(12％).结论 PTRAS能够改善老年人肾动脉粥样硬化所致肾功能改变,并使肾功能长期保持稳定.加强对军队老干部PTRAS后的健康教育,可部分提高患者对相关危险因素的控制,减少术后并发症的发生,提高生活质量.%Objective To study the effect of percutaneous transluminal renal artery stenting (PTRAS) on kidney function of patients with atherosclerotic renal arterigraphy stenosis(ARAS). Methods Serum creatinine level and incidence of restenosis were retrospectively analyzed in 50 renal arteriography-diagnosed ARAS patients who were followed up for 3 ?48 months(16. 3 + 14. 8 months). Results The PTRAS was successful in 50 ARAS patients. The serum creatinine level was significantly lower in 20 patients(40%) with their kidney function improved and in 26 patients(52%) with their kidney function stablized while it was significantly higher in 4 patients (8%) with their kidney function deteriorated after operation than before operation (151. 47 + 54. 86 jumol/L vs 182. 50 ?68. 87 jumol/L, P<0. 01, 95. 56 ?12. 87 nmol/L vs .101. 37 + 15. 53 jitmol/L,P<0. 05). Restenosis occurred in 6 patients(12%) during the follow up. Conclusion PTRAS can improve the kidney function of elderly ARAS patients and keep it stable for a long time. Strenthing health education in elderly ARAS patients can contribute to the control of relevant risk factors,decrease their complications,and improve their quality of life after PTRAS.
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