肾动脉狭窄形态对其血流动力学的影响
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国家自然科学基金项目(11827803,11421202)


Influences of Renal Artery Stenosis Morphology on its Hemodynamics
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    摘要:

    目的 探讨肾动脉狭窄(renal artery stenosis, RAS)的形态学参数对其血流动力学的影响,为临床治疗提供理论参考。方法 创建理想化RAS模型,运用计算流体力学方法探讨狭窄面积、对称性、长度和形状改变对肾动脉血流动力学影响。结果 肾灌注、压降和壁面剪切力分布与狭窄面积显著相关。当狭窄面积从50%逐步增大到70%,这些血流动力学参数均发生显著变化。此外,非对称狭窄会显著增加肾动脉中的回流区以及非正常高壁面剪切力,但狭窄长度和狭窄形状的改变对肾动脉的血流动力学影响较小。结论 虽然狭窄面积仍是RAS各种形态参数中最显著的影响因素,但是其他形态学参数尤其是非对称狭窄对肾动脉血流动力学影响也不可忽略,建议临床医生的治疗方案应该基于这些形态学参数进行综合评估。

    Abstract:

    Objective To investigate the hemodynamic effects of morphological parameters on renal artery stenosis (RAS), so as to provide theoretical references for clinical practice. Methods The idealized models of RAS were established, then the hemodynamic effects from morphological parameters of stenosis including its area, symmetry, length and shape on renal artery was explored using computational fluid dynamics (CFD) method. Results The renal perfusion, pressure drop and wall shear stress (WSS) distributions in renal artery were significantly correlated with area stenosis (AS). When the stenosis area increased from 50% to 70%, all hemodynamic parameters changed significantly. In addition, an asymmetrical stenosis resulted in a significant increase of abnormally high WSS and length of recirculation flow in renal artery, but the change of stenosis length or shape only led to marginal changes in hemodynamics. Conclusions Although AS is still the most significant factor to influence hemodynamics in RAS, other morphological parameters, especially asymmetric stenosis, cannot be neglected. Therefore, it is suggested that clinical treatment plans should be a comprehensive evaluation based on these morphological parameters.

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熊柱翔,袁丁,郑庭辉,樊瑜波.肾动脉狭窄形态对其血流动力学的影响[J].医用生物力学,2021,36(3):389-395

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  • 收稿日期:2020-05-22
  • 最后修改日期:2020-07-16
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  • 在线发布日期: 2021-07-05
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