南方医科大学学报

南方医科大学学报 ›› 2006, Vol. 26 ›› Issue (07): 997-1000.

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肾静脉肾素水平与肾动脉介入治疗疗效的相关性研究

冯颖青； 周颖玲； 罗建方； 余丹青； 陈纪言；   

  1. 广东省人民医院心内科； 广东省人民医院心内科 广东广州510100； 广东广州510100；
  • 出版日期:2006-07-20 发布日期:2006-07-20
  • 基金资助:
    广东省科技厅科技攻关项目(G312013)~~

Study of correlation between renal vein renin and therapeutic effect of percutaneous renal artery stenting

FENG Ying-qing, ZHOU Ying-ling, LUO Jian-fang, YU Dan-qing, CHEN Ji-yan Department of Cardiology, People’s Hospital of Guangdong Province, Guangzhou 510080, China   

  1. 广东省人民医院心内科； 广东省人民医院心内科 广东广州510100； 广东广州510100；
  • Online:2006-07-20 Published:2006-07-20

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摘要： 目的探讨肾静脉肾素活性,血浆内皮素(ET)、一氧化氮(NO)、钙素基因相关肽(CGRP)水平对肾动脉狭窄介入治疗疗效的预测价值。方法60例冠心病合并高血压患者经肾动脉造影,证实为肾动脉狭窄,予肾动脉支架植入术;测定所有病例介入治疗前后的肾静脉肾素活性和血浆ET、NO、CGRP水平。并对病人的血压进行2年随访。结果60例患者根据术前肾素水平分为肾素比值(RVRR)>1.5组和RVRR<1.5组。所有患者肾动脉狭窄侧肾静脉肾素活性高于对侧[(3.89±3.14)nmol/L/h和(2.01±1.93)nmol/L/h,P<0.05],介入治疗后患侧肾静脉肾素浓度明显下降,RVRR>1.5组低于RVRR<1.5组[(1.92±2.15)nmol/L/h和(2.42±0.56)nmol/L/h,P<0.05],血浆ET和NO水平与RVRR<1.5组相比有统计学差异(P<0.05),术后血压明显下降,血压有效率75.68%,与RVRR<1.5组比P<0.05。结论测定肾静脉肾素活性,血浆ET、NO的水平对肾动脉血管成形术近期疗效有预测价值。

Abstract: Objective To assess the value of renal vein renin , plasma endothelin (ET), nitric oxide (NO), calcitonin gene-related peptide (CGRP) in predicting the therapeutic effect of percutaneous renal artery stenting. Methods Selective renal angiography was performed in 60 patients with coronary artery disease and hypertension. All the patients with obvious unilateral renal artery stenosis (lumen narrowing >or =50%) underwent percutaneous transluminal renal angioplasty and stenting. Bilateral renal vein and inferior vena cava plasma renin activity (PRA) and plasma ET, NO, and CGRP levels were measured and the two-year follow-up data of the patients analyzed. Results In all the patients, PRA in the ischemic kidney was significantly higher than that in the contralateral kidney (3.89±3.14 vs 2.01±1.93 nmol/L/h, P<0.05). After renal artery revascularization with stenting, PRA in the ischemic kidney was reduced obviously (P<0.05), which was significantly lower in patients with renal vein renin ratio (RVRR)>1.5 than in those with RVRR <1.5 (1.92±2.15 vs 2.42±0.56 nmol/L/h, P<0.05]. Plasma ET level was significantly higher, whereas plasma NO level significantly lower in patients with PVRR>1.5 (P<0.05). Greater improvement of blood pressure was observed in patients with RVRR>1.5 after two years than in those with RVRR< 1.5 (P<0.05). Conclusion The activity of penal vein renin, plasma ET, NO, and CGRP may provide valuable information for predicting the therapeutic effect of percutaneous renal artery stenting.

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