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经皮腔内血管成形术联合支架置入治疗移植肾动脉狭窄的临床分析

顾世杰 陈秋源 崔瑞文 马晴 马麟 石小红 孟凡航 曹荣华

顾世杰, 陈秋源, 崔瑞文, 等. 经皮腔内血管成形术联合支架置入治疗移植肾动脉狭窄的临床分析[J]. 器官移植, 2021, 12(2): 215-219. doi: 10.3969/j.issn.1674-7445.2021.02.013
引用本文: 顾世杰, 陈秋源, 崔瑞文, 等. 经皮腔内血管成形术联合支架置入治疗移植肾动脉狭窄的临床分析[J]. 器官移植, 2021, 12(2): 215-219. doi: 10.3969/j.issn.1674-7445.2021.02.013
Gu Shijie, Chen Qiuyuan, Cui Ruiwen, et al. Clinical analysis of percutaneous transluminal angioplasty combined with stent implantation in the treatment of transplant renal artery stenosis[J]. ORGAN TRANSPLANTATION, 2021, 12(2): 215-219. doi: 10.3969/j.issn.1674-7445.2021.02.013
Citation: Gu Shijie, Chen Qiuyuan, Cui Ruiwen, et al. Clinical analysis of percutaneous transluminal angioplasty combined with stent implantation in the treatment of transplant renal artery stenosis[J]. ORGAN TRANSPLANTATION, 2021, 12(2): 215-219. doi: 10.3969/j.issn.1674-7445.2021.02.013

经皮腔内血管成形术联合支架置入治疗移植肾动脉狭窄的临床分析

doi: 10.3969/j.issn.1674-7445.2021.02.013
基金项目: 

广东省医学科学技术研究基金 2019KT1252

广东省科技计划项目研究基金 2016KT1167

详细信息
    作者简介:

    顾世杰, 男, 1988年生, 硕士, 住院医师, 研究方向为肾脏缺血- 再灌注损伤的机制及预防, Email: doctorgushijie@163.com

    通讯作者:

    曹荣华, 男, 1968年生, 博士, 副主任医师, 研究方向为肾移植术后排斥反应的机制研究, Email: crh98@163.com

  • 中图分类号: R617, R692, R814

Clinical analysis of percutaneous transluminal angioplasty combined with stent implantation in the treatment of transplant renal artery stenosis

More Information
  • 摘要:   目的  探讨经皮腔内血管成形术(PTA)联合支架置入治疗肾移植术后移植肾动脉狭窄(TRAS)的临床疗效。  方法  回顾性分析21例肾移植术后TRAS行PTA联合支架置入治疗患者的临床资料。总结肾移植受者中TRAS的发生情况,比较TRAS患者介入治疗前后相关指标变化情况,分析TRAS患者的预后情况。  结果  507例肾移植受者中有21例发生TRAS,发生率为4.1%(21/507)。TRAS诊断时间为术后5(4,7)个月,67%(14/21)在术后6个月内出现TRAS。与介入治疗前比较,介入治疗后1周和1个月TRAS患者血清肌酐、收缩压、舒张压以及移植肾动脉峰值血流流速均降低,估算肾小球滤过率(eGFR)、叶间动脉阻力指数均升高,差异均有统计学意义(均为P < 0.05)。PTA联合支架置入术后随访期间,共有1例出现移植肾动脉再发狭窄,经单纯球囊扩张后好转,1例右股动脉穿刺点假性动脉瘤形成,1例移植肾动脉闭锁导致肾脏萎缩失功,其余18例术后均恢复良好。  结论  PTA联合支架置入是肾移植术后TRAS首选治疗方式,可明显改善移植肾功能,显著延长移植肾的生存时间。
  • 图  1  肾移植术后TRAS患者PTA联合支架置入治疗前后表现

    注:A图示介入治疗前移植肾动脉起始部严重狭窄;B图示PTA联合支架置入后动脉狭窄消失,血管充盈明显。

    Figure  1.  Performance of a patient with TRAS after renal transplantation before and after PTA combined with stent implantation

    表  1  TRAS患者介入治疗前后相关指标的变化情况

    Table  1.   Changes of relevant indexes in patients with TRAS before and after interventional treatment(x±s)

    时间 n 血清肌酐(μmol/L) eGFR(mL/min) 收缩压(mmHg) 舒张压(mmHg) 动脉峰值血流流速(cm/s) 叶间动脉阻力指数
    介入治疗前 21 203±100 41±21 150±16 92±11 377±97 0.52±0.08
    介入治疗后
      1周 21 163±73a 49±20a 132±14a 82±7a 151±49a 0.59±0.06a
      1个月 21 154±71a, b 52±20a, b 128±12a, b 78±6a, b 148±56a 0.61±0.07a
    注:与介入治疗前比较,aP < 0.05;与介入治疗后1周比较,bP < 0.05;10 mmHg=1.33 kPa。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2020-11-23
  • 网络出版日期:  2021-03-19
  • 刊出日期:  2021-03-15

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