动脉粥样硬化性肾动脉狭窄的发生率及其相关危险因素分析
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Incidence and Risk Factors of Atherosclerotic Renal Artery Stenosis
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    目的对疑似冠心病或急性、慢性心肌梗死的患者进行冠状动脉造影及肾动脉造影,分析动脉粥样硬化性肾动脉狭窄的发生率及其相关危险因素。方法对279例接受冠状动脉造影的患者进行腹主动脉数字减影血管造影检查。结果279例患者中,动脉粥样硬化性肾动脉狭窄(≥30%)发生率为28.7%;经冠状动脉造影证实的175例冠心病患者中,肾动脉狭窄(≥30%)的发生率为34.3%;冠状动脉造影完全正常的104例患者中,20例有肾动脉狭窄,冠状动脉多支病变发生肾动脉狭窄的机率增加;多因素Logistic回归分析显示,吸烟、脉压、血肌酐及冠状动脉狭窄积分是动脉粥样硬化性肾动脉狭窄的相关预测因素。结论对冠心病合并高血压的患者,冠状动脉造影时应常规进行腹主动脉造影检查,以尽早发现动脉粥样硬化性肾动脉狭窄。

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    Aim To evaluate the incidence and risk factors of atherosclerotic renal artery stenosis(ARAS) undergoing coronary angiography.Methods A total of 279 consecutive Chinese patients with coronary artery desease confirmed by coronary angiography underwent an abdominal aortogram in the same sitting to screen for ARAS.Patient demographics and comorbidities were analyzed for any association with ARAS.Results A total of 80(28.7%) patients was found to have significant ARAS,60(34.3%) of the 175 patients with coronary artery desease who had at least one coronary artery of ≥50% diameter stenosis,20 cases had atherosclerotic renal artery stenosis in 104 patients of normal coronary arteriography.The frequency of ARAS increased with the number of stenotic coronary arteries.By multivariate logistic regression analysis,smoking,pulse pressure(PP),coronary artery stenosis,and serum creatinine were independent predictors of ARAS.Conclusion Abdominal DSA should be routinely performed in patients with coronary artery desease undergoing coronary angiography to identify ARAS,especially in those associated with hypertension and coronary artery disease.

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李晖, 孙晓凤, 张源明.动脉粥样硬化性肾动脉狭窄的发生率及其相关危险因素分析[J].中国动脉硬化杂志,2011,19(5):427~430.

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  • 收稿日期:2010-12-23
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