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肾动脉粥样硬化栓子的临床表现、评估和治疗

Author
Francesco Scolari, MD
Section Editor
Gary C Curhan, MD, ScD
Deputy Editor
John P Forman, MD, MSc
Translators
乐偲, 主治医师

引言

肾脏和全身性的动脉粥样硬化栓子(又称为胆固醇结晶栓子)常发生于存在弥漫性侵蚀性动脉粥样硬化的年龄较大的患者。当动脉粥样硬化斑块的部分破裂并栓塞远端时，就会发生胆固醇结晶栓塞，它能导致多处小动脉(或肾小球微动脉)部分或完全闭塞，引起组织或器官缺血[1]。

与肾脏动脉粥样硬化栓子相关的临床议题将总结在此。对胆固醇结晶栓塞的总体论述和血栓栓塞性肾梗死的讨论参见其他专题。 (参见“动脉粥样硬化斑块导致的栓塞：动脉粥样硬化栓塞(胆固醇结晶栓塞)”和“肾梗死”)

危险因素

动脉粥样硬化栓塞是严重动脉粥样硬化的一种并发症。因此，动脉粥样硬化栓塞性疾病的危险因素(如，年龄较大、男性、糖尿病、动脉高血压、高胆固醇血症及吸烟)与发生动脉粥样硬化的危险因素相同[2-7]。 (参见“Overview of the risk equivalents and established risk factors for cardiovascular disease”, section on ‘Established risk factors for atherosclerotic CVD’)

激发事件 — 动脉粥样硬化斑块一旦形成，可能因多种激发事件而破裂，引起胆固醇结晶栓塞。这些激发事件可以大致分为如下类型：

●医源性事件，常由血管造影、心血管手术或抗凝治疗诱发

           

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Literature review current through: 2017-06 . | This topic last updated: 2016-01-04.
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