摘要
目的 了解以肾素 钠图为基础的肾素分型在肾性高血压中的分布情况 ,并评估开搏通试验在肾动脉狭窄筛选中的临床价值。方法 5 6例不同肾功能的肾性高血压患者进行了肾素 钠测定和开搏通试验 ,并观察了试验前后的肾素、醛固酮和血压的变化。结果 随着肾功能的恶化 ,高肾素型高血压的比例 (5 6 % )逐步下降 ,低肾素型的比例明显升高 (P <0 0 5 )。与肾实质疾病患者相比 ,肾动脉狭窄患者在开搏通试验后血浆肾素活性明显升高 ,而血清醛固酮显著下降。在肾功能正常组中开搏通试验的敏感性为 10 0 % ,随着肾功能下降其敏感性下降至 33%。结论 随着肾功能的恶化 ,低肾素型患者的比例升高提示钠离子介导的水钠潴留成为高血压的主要机理。在筛选肾动脉狭窄的开搏通试验中 ,试验前后肾素、醛固酮的变化有诊断意义。而肾功能受损会影响开搏通试验的敏感性。
Objective To learn about the distribution of renin sodium profile in renal hypertension and evaluate the value of Capoten test in screening renal artery stenosis.Methods Renin sodium profile and Capoten test were performed in fifty six patients with renal hypertension.The changes of renin,aldosterone and blood preesure were observed before and after test.Results Along with the deterioration of renal function,the ratio of high renin form decreased,and the ratio of low renin form increased significantly (P<0 05).Comparing with renal parenchyma hypertension,plasma renin activity increased significantly after Capoten test in renal artery stenosis and serum aldosterone level decreased significantly.In normal renal function group,the sensitivity of capoten test was 100%,but in renal insufficiency,the sensitivity of the test decreased to 33%.Conclusion Volume expansion mediated by sodium becomes a major mechanism of hypertension in renal insufficiency.In Capoten test,both the changes of plasma renin activity and aldosterone are important in diagnosing renal artery stenosis.Impairment of renal function would influence the sensitivity of Capoten test.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
1999年第5期307-310,共4页
Chinese Journal of Nephrology
关键词
肾性高血压
肾素-钠图
开搏通试验
Hypertension Renin sodium profile Renal artery stenosis Capoten test
