血浆肾素活性和血管紧张素Ⅱ在肾血管性高血压病人中的临床应用

本文对26例肾血管性高血压(RVH)病人外周血,双侧肾静脉血及下腔静脉血中血浆肾素活性(PRA)及血管紧张素Ⅱ(AT Ⅱ)的测定结果及其有关因素进行了分析,得出如下结论:(1)本组单侧RVH病人肾静脉肾素活性比值(RVRR)的阳性率为53.8％;ATⅡ比值阳性率为45.5％。(2)本组单侧RVH病人的近期手术疗效在达到和未达到阳性标准的病人间无明显差异。(3)RVH肾静脉血中的PRA和ATⅡ有高、正常和降低三种类型。(4)肾实质受损,PGE和激素缺乏是某些正常和低肾素型RVH的可能病因。(5)RAAS,KKS和PGS多指标的测定和观察可能有助于阐明正常和低肾素型RVH的发病机理,并有助于提高诊断符合率和选择手术病人的阳性率。

The Clinical Application of PRA and ATII in Patients with Renovascular Hypertension

In this article, an analysis of the PRA (plasma renin activity) and ATⅡ (angio- tensin Ⅱ) levels of blood samples from peripheral vein, bilateral renal veins and inferior caval vein and renin related factors in 26 cases of renovascular hype- rtension (RVH) was performed. The conclusions were as follow: (1) The positive rate of renal vein renin ratio (RVRR) was 45.5--53.8% in the unilateral RVH patients. (2) There was no difference in short- term curative effect between the patients with unilateral RVH who have positive and negative diagnostic ratios. (3) The renin activity of blood samples from the renal vein of the affected side can be either high, normal or low. (4) The etiology of some patients with normal and low renin RVH was possibly renal parenchymal involvement, PGE or kinin deficiency. (5) We believe that multiple determina- tions and multiple index observations of RAAS, KKS and PGS can help to clarify the pathogenesis and enhance the positive diagnostic rate of RVH and to pinpoint the indications for surgery.