《国际循环》：是否有大型临床试验比较了血运重建联合药物治疗和单用药物治疗对肾血管性高血压肾功能的影响？

     <International Circulation>: Do we have any large-scale clinical trials that have examined the benefits of revascularization compared to medical treatment alone to improve renal function in patients with renovascular hypertension?

     Lerman教授：迄今为止，该领域规模最大的试验是荷兰的STAR试验和英国的ASTRAL试验。这两项研究都未能证实血运重建联合药物治疗比单纯的药物治疗更好。但是，目前还有一项美国的试验正在进行当中，即肾动脉粥样硬化病变的心血管转归试验（CORAL）。该试验由美国国立卫生研究院（NIH）资助，纳入数百例患者，随机分入最佳药物治疗组和血运重建组。CORAL试验的结果将于2012年揭晓。但是，需要特别指出的是，目前的几项研究均未能证实血运重建治疗具有显著益处。

    Prof. Lerman: The largest trials that have been recently published are the STAR trial and the ASTRAL trial from the Netherlands and the UK. These studies failed to find a benefit for revascularization compared to medical therapy alone. However， we are still waiting for the results of an ongoing trial in the US called the CORAL trial， which is an NIH funded trial of several hundred patients who have been randomized to optimal medical therapy and revascularization. I believe the results of this trial are not due until 2012 so we are still waiting for the results but so far the results of other trials have failed to detect a significant benefit for revascularization.

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