分侧肾静脉肾素测定比值与肾血管性高血压术后疗效关系的探讨  

Appraisal of therapeutic effect of operative treatment on renal vascular hypertension by detecting renal vein renin

作　　者：陆旭辉[1] 林伯贤[1] 

机构地区：[1]上海第二医科大学附属瑞金医院,高血压研究所200025

出　　处：《上海医学》2004年第6期384-385,共2页Shanghai Medical Journal

摘　　要：目的　通过对经介入或手术治疗的肾动脉狭窄患者 2年的随访 ,探讨分侧肾静脉肾素测定对肾血管性高血压术后疗效的预测价值。方法　单侧肾动脉狭窄性高血压患者 4 2例 ,分别行肾动脉球囊扩张术、支架置放术或血管重建术。术前检测血肌酐和肾血流 ,术中测定分侧肾静脉肾素水平。记录患者术前、术后 1周内、6个月、2 4个月的血压。血压明显改善的标准 :收缩压 (SBP)及舒张压 (DBP)均下降≥ 2 0mmHg(1mmHg =0 .133kpa) ;或DBP下降≥ 10mmHg ,且血压 <14 0 / 90mmHg。 结果　 4 2例患者中 ,术后双侧肾静脉肾素测定比值≥ 2 .0有 19例 ,1.5～ 1.9有 11例 ,<1.5有 12例。术后 1周内血压明显改善者中 ,肾素比值≥ 2 .0有 19例 ,1.5～ 1.9有 8例 ,<1.5有 6例 ;术后 6个月血压明显改善者中 ,肾素比值≥ 2 .0有 17例 ,1.5～ 1.9有 6例 ,<1.5有 4例 ;术后 2 4个月血压明显改善者中 ,肾素比值≥ 2 .0有 15例 ,1.5～ 1.9有 5例 ,<1.5有 2例。结论　测定肾素比值对单侧肾动脉狭窄引起的高血压患者近期 (术后至 2年 )血压的改善有预测价值。Objective To appraise the diagnostic and therapeutic effect of interventional or operatior treatment of renal vascular hypertension by detecting renal vein renin.Methods 42 patients with unilateral renal artery stenosis were followed-up for 2 years in this study. The interventronal therapies were listed as percutaneous transluminal renal artery balloon dilatation, stent implantation and vascular reconstruction. Renal vein renin , serum creatinine and renal blood flow were determined before operation. Blood pressure (BP) was also measured before and 1 week, 6 months, 24 months after operation. The improvement criteria of BP were: SBP and DBP≥20 mm Hg, or DBP≥10 mm Hg and BP<140/90 mm Hg.Results The ratio of bitateral renal vein renin determined in 42 patients: 19 were≥2.0, 11 were 1.5～1.9, 12 were <1.5. The improvement of BP one week after operation: the rennin ratio was ≥2.0, 1.5～1.9 and <1.5 in 19, 8 and 6 cases, respectively. The BP 6 months after operation: the above findings were seen in 17, 6 and 4 cases, and 2 years after operation, the above findings were observed in 15, 5 and 2 cases. Conclusion Close relationship between BP improvement in renal vascular hypertension patient after operation and renal vein renin is obvious in this study.

关 键 词：肾静脉肾素 测定 比值 肾血管性高血压 术后 疗效观察 

分 类 号：R699.2[医药卫生—泌尿科学]