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肾动脉纤维肌性发育不良的治疗

Author
Jeffrey W Olin, DO
Section Editor
George L Bakris, MD
Deputy Editor
John P Forman, MD, MSc
Translators
杜晓刚, 主任医师，教授

引言

纤维肌性发育不良(fibromuscular dysplasia, FMD)是一种非炎症性非动脉粥样硬化性疾病，可导致动脉狭窄、动脉瘤和动脉夹层。目前几乎在所有动脉床中均观察到存在FMD，最常受累的动脉是肾动脉和颈内动脉，其次是椎动脉、髂动脉、锁骨下动脉及内脏动脉。如果FMD发生在冠状动脉，患者通常因自发性冠脉夹层就诊。

根据受累动脉段和病情严重程度的不同，该病的表现可能有很大差异，最常见的首发表现是高血压、头痛、搏动性耳鸣和眩晕。不太常见的表现是短暂性脑缺血发作(transient ischemic attack, TIA)和脑卒中。

肾动脉FMD患者的治疗方法包括单纯药物治疗，或通过经皮腔内血管成形术(percutaneous transluminal angioplasty, PTA)或手术进行血运重建[1]。然而，无论是否进行血管成形术，均应对高血压进行治疗。

本文将总结肾动脉FMD的治疗。该病的临床表现和诊断、动脉粥样硬化性肾血管疾病和肾脏缺血引起的慢性肾脏疾病的治疗将单独讨论。 (参见“纤维肌性发育不良的临床表现和诊断”和“单侧动脉粥样硬化性肾动脉狭窄的治疗”和“动脉粥样硬化性双侧肾动脉狭窄或孤立有功能肾肾动脉狭窄的治疗”和“动脉粥样硬化性肾动脉狭窄引起的慢性肾脏病的临床表现及诊断”)

肾动脉纤维肌性发育不良的治疗

肾动脉FMD最常见的表现是高血压，这是由肾动脉狭窄导致的(参见“纤维肌性发育不良的临床表现和诊断”，关于‘临床表现’一节)。FMD患者高血压的处理方法包括降压药物治疗和血运重建。

            

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Literature review current through: 2017-06 . | This topic last updated: 2015-09-08.
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