Evaluation of assessment method of renal microcirculation dysfunction using pressure wire, Doppler guide wire and NO catheter.

本研究的目的是探讨经皮肾血管成形术（PTRA）后肾血流储备（RFR）和肾阻力指数（RI）是否与PTRA术后肾功能相关。RFR定义为在充血期间使用多普勒导丝（FloWire, Volcano therapeutics， USA）的肾动脉平均峰值速度（APV）除以基线时的APV。以充血时平均血压与APV之比计算RI。随访时观察RFR与肌酐清除率（CCr）、血压、降压药用量的关系。随访期间，CCr、血压、降压药数量无明显变化。高（>=1.9）RFR患者的Ccr显著高于低（<1.9）RFR患者（41.2±15.3 vs 49.6±12.9,p=0.045）低（<=2.7）RFR患者的Ccr显著高于高（>= 2.7）RFR患者（51.2±8.8 vs 30.0±11.2,p=0.012） PTRA术后即刻肾血流储备和肾阻力指数可预测PTRA术后后期肾功能。

The purpose of this study was to investigate whether renal flow reserve(RFR) and renal resistance index(RI) after percutaneous renal angioplasty(PTRA) correlate with renal function late after PTRA.RFR was defined as renal artery averaged peak velocity(APV) using a Doppler guide wire(FloWire, Volcano therapeutics, USA) during hyperemia divided by that at baseline. RI was calculated as the ratio of mean blood pressure to APV at hyperemia. The relationship between RFR and creatinine clearance(CCr), blood pressure, the number of anti-hypertensive drugs at follow-up was investigated.During follow-up, CCr, blood pressure, and the number of anti-hypertensive drugs did not change significantly. Ccr at follow-up was significantly higher in patients with high(>=1.9) RFR than low(<1.9) RFR.(41.2±15.3 vs. 49.6±12.9, p=0.045) Ccr at follow-up was higher in patients with low(<=2.7) RI than high(> 2.7) RI.(51.2±8.8 vs. 30.0±11.2, p=0.012)Renal flow reserve and renal resistance index immediately after PTRA may predict renal functional late after PTRA.