顽固性高血压与动脉病变课件.ppt

北京大学人民医院 王鲁雁;顽固性高血压 定义;顽固性高血压;顽固性高血压;;顽固性高 血 压;高 血 压;;;动脉与血压形成 ;;150;;;动脉脉搏波分析(PWA);;脉搏波传导速度（PWV）;动脉结构病变：粥样硬化;Scheme of Atheromatous Plaque;;;;高血压患者临床特征及其与颈动脉粥样硬化之间的关系 （n=224）;Prevalence of PAD ——increases with age;Newman AB et al. Circulation 1993; 88: 837-845. TASC Working Group. J Vasc Surg 2000; 31 (1, pt 2): S1-S288. Djousse PM et al. Circulation 2000; 102: 3092-3097.;Mortality is very high in patients with severe PAD;;;;;肾动脉狭窄Renal artery stenosis (RAS);6.8% of people aged ≥ 65y 22% to 59% of patients with PAD have hemodynamically significant RAS (as defined by a stenosis ≥50%) MI, 12% of postmortem examinations demonstrate the presence of an RAS of 75% or greater. Hypertension 20％, (70％);顽固性高血压--肾动脉狭窄;肾动脉狭窄 病因;慢性缺血性肾病CIRD(chronic ischemic renal disease);;慢性缺血性肾病 病理改变;Clinical Clues to the Diagnosis of RAS;new azotemia or worsening renal function after the administration of an ACEI or ARB unexplained atrophic kidney or a discrepancy insize between the 2 kidneys of greater than 1.5 cm sudden, unexplained pulmonary edema ;临床特点;检测手段—超声;;;螺旋CT血管造影(CTA)磁共振血管成像(MRA) X线血管造影检查(DsA）;肾动脉狭窄的治疗;药物治疗;Blood Pressure Outcome of Angioplasty in Atherosclerotic Renal Artery Stenosis A Randomized Trial;Trial profile ;;;CONCLUSION;Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function ;;;目前研究;总结;积极控制血压预防动脉病变减少RAS;THANK YOU ！