中国脑血管病杂志
中國腦血管病雜誌
중국뇌혈관병잡지
CHINESE JOURNAL OF CEREBROVASCULAR DISEASES
2015年
4期
185-188
,共4页
张正善%杨怀滔%张睿%段炼
張正善%楊懷滔%張睿%段煉
장정선%양부도%장예%단련
脑底异常血管网病%肾动脉梗阻%疾病特征%血管内治疗
腦底異常血管網病%腎動脈梗阻%疾病特徵%血管內治療
뇌저이상혈관망병%신동맥경조%질병특정%혈관내치료
Moyamoya disease%Renal artery obstruction%Disease attributes%Endovascular treatment
目的探讨烟雾病合并肾动脉狭窄（RAS）的临床特征及治疗预后。方法回顾性分析解放军第三0七医院神经外科2009年3月至2012年6月收治的15例烟雾病合并RAS患者及基线情况匹配的30例无RAS烟雾病患者的首发症状、颅内血管病变情况、肾动脉病变情况、治疗及随访结果等临床资料。结果（1）烟雾病合并RAS 患者占同期收治的烟雾病患者总数的1．6％（15／927）。RAS组左侧RAS有5例，右侧RAS有4例，双侧RAS有6例；轻度狭窄占71．4％（15／21侧），近端狭窄占85．7％（18／21侧）；RAS 组高血压患者（80．0％，12例）显著高于无RAS烟雾病组（30．0％，9例），差异有统计学意义（χ2＝10．045，P ＜0．05）。两组患者铃木分期分布差异有统计学意义（Z ＝－6．184，P ＜0.01）。（2）对RAS行介入治疗的4例，术后血压均下降至正常。介入治疗后造影随访3例，随访时间9～108个月，肾动脉均无再狭窄发生。结论烟雾病RAS患者的高血压患病率较未合并RAS显著升高，并且颅内血管病变程度与未合并RAS患者存在差异。RAS以近端、轻度狭窄为主，血管介入治疗烟雾病合并严重RAS有效，但长期预后需进一步随访。
目的探討煙霧病閤併腎動脈狹窄（RAS）的臨床特徵及治療預後。方法迴顧性分析解放軍第三0七醫院神經外科2009年3月至2012年6月收治的15例煙霧病閤併RAS患者及基線情況匹配的30例無RAS煙霧病患者的首髮癥狀、顱內血管病變情況、腎動脈病變情況、治療及隨訪結果等臨床資料。結果（1）煙霧病閤併RAS 患者佔同期收治的煙霧病患者總數的1．6％（15／927）。RAS組左側RAS有5例，右側RAS有4例，雙側RAS有6例；輕度狹窄佔71．4％（15／21側），近耑狹窄佔85．7％（18／21側）；RAS 組高血壓患者（80．0％，12例）顯著高于無RAS煙霧病組（30．0％，9例），差異有統計學意義（χ2＝10．045，P ＜0．05）。兩組患者鈴木分期分佈差異有統計學意義（Z ＝－6．184，P ＜0.01）。（2）對RAS行介入治療的4例，術後血壓均下降至正常。介入治療後造影隨訪3例，隨訪時間9～108箇月，腎動脈均無再狹窄髮生。結論煙霧病RAS患者的高血壓患病率較未閤併RAS顯著升高，併且顱內血管病變程度與未閤併RAS患者存在差異。RAS以近耑、輕度狹窄為主，血管介入治療煙霧病閤併嚴重RAS有效，但長期預後需進一步隨訪。
목적탐토연무병합병신동맥협착（RAS）적림상특정급치료예후。방법회고성분석해방군제삼0칠의원신경외과2009년3월지2012년6월수치적15례연무병합병RAS환자급기선정황필배적30례무RAS연무병환자적수발증상、로내혈관병변정황、신동맥병변정황、치료급수방결과등림상자료。결과（1）연무병합병RAS 환자점동기수치적연무병환자총수적1．6％（15／927）。RAS조좌측RAS유5례，우측RAS유4례，쌍측RAS유6례；경도협착점71．4％（15／21측），근단협착점85．7％（18／21측）；RAS 조고혈압환자（80．0％，12례）현저고우무RAS연무병조（30．0％，9례），차이유통계학의의（χ2＝10．045，P ＜0．05）。량조환자령목분기분포차이유통계학의의（Z ＝－6．184，P ＜0.01）。（2）대RAS행개입치료적4례，술후혈압균하강지정상。개입치료후조영수방3례，수방시간9～108개월，신동맥균무재협착발생。결론연무병RAS환자적고혈압환병솔교미합병RAS현저승고，병차로내혈관병변정도여미합병RAS환자존재차이。RAS이근단、경도협착위주，혈관개입치료연무병합병엄중RAS유효，단장기예후수진일보수방。
Objective To investigate the clinical features and prognosis of patients with moyamoya disease and renal artery stenosis. Methods The clinical data such as the first symptom,intracranial vascular lesions,renal artery lesions,treatment and follow-up results of the 15 patients with moyamoya disease and complicated with renal artery stenosis (RAS group)and the baseline-matched 30 moyamoya diseased patients without renal artery stenosis (MMD group)treated at the Department of Neurosurgery,the 307 th Hospital of People′s Liberation Army from March 2009 to June 2012 were analyzed retrospectively. Results (1)The moyamoya diseased patients with renal artery stenosis accounted for 1. 6%(15 / 927)of the total number of patients with moyamoya disease admitted in the same period. In the RAS group,the left renal artery stenosis accounted for 5 cases,the right renal artery stenosis accounted for 4 cases,and the bilateral renal artery stenosis accounted for 6 cases. Mild stenosis accounted for 71. 4%(15 / 21 sides), proximal stenosis accounted for 85. 7% (18 / 21 sides). The incidence of hypertension (80. 0%,n = 12) of the RAS group was significantly higher than that of the MMD group (30. 0%,n =9). There was significant difference (χ2 = 10. 045,P < 0. 05). There was significant difference in the distribution of Suzuki stage between the patients of the two groups (Z = -6. 184,P <0. 01). (2)Four patients underwent interventional therapy,their blood pressure decreased to normal level after procedure. Three patients were followed up for 9 months to 108 months with angiography after interventional treatment. No restenosis occurred in renal artery. <br> Conclusion The incidence of hypertension in patients with RAS is significantly higher than that without RAS,and there is difference between the degree of intracranial vascular lesions and the patients without RAS. Renal artery stenosis is mainly the proximal mild stenosis. Interventional therapy is an effective method for the treatment of moyamoya disease with severe renal artery stenosis;however,the long-term prognosis needs to be further followed up.
