【摘要】：目的探討腎動(dòng)脈狹窄患者粥樣硬化斑塊IVUS及VH-IVUS特征和介入治療后短期療效的相關(guān)性。 方法共納入25名患者（2008年1月1日至2013年11月30日），，通過(guò)腎動(dòng)脈造影、IVUS檢查（其中VH-IVUS檢查17例）評(píng)估腎動(dòng)脈狹窄病變并進(jìn)行經(jīng)皮腎血管成形術(shù)治療，隨訪術(shù)后1周、3月及6月血清肌酐、血壓水平，并分別計(jì)算eGFR值。 結(jié)果在灰階IVUS檢查數(shù)據(jù)中，僅斑塊面積和術(shù)前eGFR呈顯著相關(guān)（r=-0.448，p=0.025），VH-IVUS分析斑塊成分和術(shù)前基礎(chǔ)eGFR無(wú)統(tǒng)計(jì)學(xué)差異。資料顯示，隨訪3月、6月共7例eGFR惡化（32%），15例eGFR較術(shù)前改善（68%），術(shù)后隨訪的eGFR值總體水平高于術(shù)前水平，術(shù)后1周和6月的eGFR水平差異有統(tǒng)計(jì)學(xué)意義；隨訪1周、3月和6月的eGFR變化率和IVUS測(cè)量的病變節(jié)段最小的血管內(nèi)腔面積呈顯著相關(guān)（r=0.632，p=0.001；r=0.586，p=0.004；r=0.496，p=0.019）。術(shù)后1周的eGFR變化率和VH-IVUS測(cè)量的壞死核心及鈣化斑塊面積呈顯著負(fù)相關(guān)（r=-0.634，p=0.011；r=-0.566，p=0.028），而術(shù)后3月和6月的eGFR變化率和VH-IVUS斑塊組成無(wú)相關(guān)關(guān)系。同時(shí)，隨訪1周、3月和6月的收縮壓平均降幅分別為7.3%、10.7%和13.9%，差異有統(tǒng)計(jì)學(xué)意義，而IVUS斑塊成分和術(shù)后血壓變化無(wú)相關(guān)關(guān)系。 結(jié)論經(jīng)皮腎動(dòng)脈血管成形術(shù)可改善腎動(dòng)脈狹窄患者的腎功能和血壓水平，IVUS最小管腔面積與術(shù)后eGFR變化率呈正相關(guān)，提示IVUS斑塊分析可能對(duì)腎動(dòng)脈狹窄介入術(shù)后短期腎功能變化和血壓改變提供更多的信息。
[Abstract]:Objective to investigate the correlation between IVUS and VH-IVUS features of atherosclerotic plaques in patients with renal artery stenosis and the short-term effect after interventional therapy. Methods A total of 25 patients (January 1, 2008 to November 30, 2013) were enrolled in this study. Renal artery stenosis was evaluated by renal arteriography (VH-IVUS in 17 patients) and percutaneous renal angioplasty was performed. Serum creatinine, blood pressure and eGFR were calculated 1 week, 3 months and 6 months after operation. Results in the gray scale IVUS data, there was no significant correlation between plaque area and preoperative eGFR (r-0.448p0. 025) VH-IVUS analysis of plaque composition and preoperative basic eGFR showed no statistical difference. The data showed that 7 cases (32%) of eGFR deteriorated in 6 months (32%) and 15 cases of eGFR were improved (68%) after follow up. The total eGFR level of postoperative follow-up was higher than that of preoperative level, and the difference of eGFR level between 1 week and 6 months after operation was statistically significant. After 1 week of follow-up, there was a significant correlation between the change rate of eGFR in 3 months and 6 months and the area of the smallest vascular lumen measured by IVUS (r = 0.632p0. 001 ~ 0. 586 ~ 0. 004 ~ 0. 496p ~ (0.019). There was a significant negative correlation between the change rate of eGFR and the area of necrotic core and calcified plaque measured by VH-IVUS at 1 week after operation (r = 0.634). However, there was no correlation between the change rate of eGFR and the plaque composition of VH-IVUS in 3 and 6 months after operation. At the same time, the mean systolic blood pressure decreased by 7.3% and 13.9% in 3 months and 6 months, respectively. The difference was statistically significant, but there was no correlation between the plaque composition of IVUS and the blood pressure after operation. Conclusion Percutaneous renal artery angioplasty can improve renal function and blood pressure in patients with renal artery stenosis. The minimum lumen area of IVUS is positively correlated with the change rate of eGFR after operation. The results suggest that IVUS plaque analysis may provide more information on the changes of renal function and blood pressure after renal artery stenosis intervention.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R692

【共引文獻(xiàn)】

相關(guān)期刊論文 前8條

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