自发性肾动脉夹层的特征、治疗和结果:10 年单一中心的回顾性经验。

IF 2.9 2区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Quantitative Imaging in Medicine and Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-26 DOI:10.21037/qims-24-994
Xinzhi Yang, Pengyu Li, Bihui Zhang, Ziguang Yan, Guochen Niu, Min Yang
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引用次数: 0

摘要

背景:自发性肾动脉夹层(SRAD)是导致肾功能衰竭和新血管性高血压的罕见病因,其诊断往往被延迟,不同中心的治疗方法也各不相同。这项回顾性队列研究的目的是仔细研究本中心过去十年中 SRAD 患者的特征、治疗方式和结果。此外,该研究还试图找出最适合不同类别 SRAD 患者的治疗方案:收集了 2013 年 12 月至 2023 年 12 月期间连续出现 SRAD 症状的 21 例患者的数据。分析了病变特征、治疗方案、血压(BP)控制、血清肌酐和估计肾小球滤过率(eGFR)。血压、血清肌酐和 eGFR 的比较采用配对 t 检验。采用独立样本 t 检验分析不同治疗组的基线血压和血压变化:结果:SRAD 患者的平均年龄、体重和身高分别为 49.2±13.0(18-69)岁、69.0±9.7(50-80)公斤和 1.7±0.1(1.6-1.8)米。8例(38.1%)患者为新发高血压。分别有 1 例(4.8%)和 4 例(19.0%)患者发现肾动脉夹层动脉瘤和肾动脉狭窄。分别有 15 例、4 例和 2 例患者需要接受单纯药物支持治疗、血管内介入治疗和肾切除术。所有治疗组都获得了稳定的肾功能和满意的高血压控制,中位随访时间为 18.1 个月(12-32 个月):结论:对于大多数 SRAD 患者来说,药物治疗是一个合理的选择。结论:药物治疗是大多数 SRAD 患者的合理选择,而介入治疗是治疗新血管性高血压和保护肾功能的有效策略。
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Characteristics, treatment, and outcomes of spontaneous renal artery dissection: a 10-year retrospective single-center experience.

Background: Spontaneous renal artery dissection (SRAD) is a rare cause of renal failure and renovascular hypertension, with the diagnosis often being delayed and treatment varying across different centers. The objective of this retrospective cohort study was to scrutinize the characteristics, treatment modalities, and outcomes of patients with SRAD at our center over the past ten years. Furthermore, the study sought to identify the most suitable treatment options for different categories of patients with SRAD.

Methods: Data from 21 consecutive patients who presented with symptoms of SRAD from December 2013 to December 2023 were collected. Lesion characteristics, treatment options, blood pressure (BP) control, serum creatinine and estimated glomerular filtration rate (eGFR) were analyzed. A paired t-test was used for comparisons of BP, serum creatinine, and eGFR. An independent samples t-test was used to analyze baseline BP and BP change in different treatment groups.

Results: The mean age, weight, and height of patients with SRAD was 49.2±13.0 (range, 18-69) years, 69.0±9.7 (range, 50-80) kg, and 1.7±0.1 (range 1.6-1.8) m, respectively. New-onset hypertension was found in 8 (38.1%) patients. Renal artery dissecting aneurysm and renal artery stenosis were found in 1 (4.8%) and 4 (19.0%) patients, respectively. Supportive medical treatment alone, endovascular intervention, and nephrectomy were required in 15, 4 and 2 cases, respectively. Stable renal function and satisfactory hypertension control were obtained in all treatment groups, with a median follow-up of 18.1 (range, 12-32) months.

Conclusions: Medical management is a reasonable choice in most patients with SRAD. Interventional management is an efficacious strategy for the management of renovascular hypertension and the preservation of renal function.

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来源期刊
Quantitative Imaging in Medicine and Surgery
Quantitative Imaging in Medicine and Surgery Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
4.20
自引率
17.90%
发文量
252
期刊介绍: Information not localized
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