关键词: 纤维肌性发育不良, 肾血管性高血压, 临床特征, 诊断, 治疗

Abstract: Objective The aim of this study is to analyze the clinical characteristics of patients with renovascular hypertension caused by fibromuscular dysplasia. Methods Clinical data of 39 cases with renovascular hypertension caused by fibromuscular dysplasia treated in Peking Union Medical College Hospital from 2006 to 2017 were retrospectively reviewed. Results The mean age of the 39 patients was 22 years old, and the ratio of males and female was about 1:3 (10 males and 29 females). All patients presented with early-onset hypertension, and 67% of them had hypokalemia. Middle and distal segmental stenosis in truck of renal artery were mostly found, and mostly involved single kidney. Compared to angiography, the gold standard for diagnosis of renal artery stenosis, the diagnostic sensitivity of plasma renin activity in upright position, renal artery ultrasound, renal blood perfusion and renal function dynamic imaging, and renal artery CTA were 74%, 84%, 72% and 95%, respectively. After the treatment of percutaneous balloon angioplasty, the rate of complete remission was 38%, the partial remission rate was 45%, and the inefficiency was 17%. Conclusion Renovascular hypertension caused by fibromuscular dysplasia commonly occurs in young women with the characteristics of early-onset moderate to severe hypertension, and involves mostly middle and distal segment in the renal artery. Percutaneous balloon angioplasty is the first choice for treatment.

Key words: Fibromuscular dysplasia, renovascular hypertension, clinical features, diagnosis, treatment