Marks L S, Maxwell M H
Urol Clin North Am. 1975 Jun;2(2):311-25.
Renal vein renin determinations, in contrast to isolated peripheral venous renin determinations, provide great help in the selection of patients who can benefit from an operation for renal hypertension. Patients with essential hypertension usually have renal vein renin ratios, larger/smaller, close to unity, but the available cumulative data show that, statistically, ratios as large as 2.0 may occur in this group (95 per cent confidence limits). In patients with unilateral stenosis of a main renal artery, large renal vein renin ratios (stenotic/normal) have been followed by operative success in more than 90 per cent of patients. However, many operative successes have also been achieved in patients without a large renal vein renin ratio. This may be explained by inaccurate renal vein catheterization, inactive renin secretion, nonsimultaneous sampling, assay variability, and problems related to bilateral or segmental lesions. Recent refinements in the interpretation of renal vein renin data (contralateral suppression, ipsilateral hypersecretion in absolute terms, and a combination analysis scoring system) appear to increase the accuracy of the test. Detailed anatomic information, provided by arteriography, is essential for proper interpretation of renal vein renin data.
与孤立的外周静脉肾素测定不同，肾静脉肾素测定在选择能从肾性高血压手术中获益的患者方面有很大帮助。原发性高血压患者的肾静脉肾素比值（较大/较小）通常接近1，但现有累积数据表明，从统计学角度看，该组患者中可能出现高达2.0的比值（95%置信限）。在主肾动脉单侧狭窄的患者中，肾静脉肾素比值大（狭窄侧/正常侧）的患者手术成功率超过90%。然而，肾静脉肾素比值不大的患者也有很多手术成功的案例。这可能是由于肾静脉插管不准确、肾素分泌不活跃、采样不同步、检测变异性以及与双侧或节段性病变相关的问题所致。最近在肾静脉肾素数据解释方面的改进（对侧抑制、绝对同侧分泌亢进以及联合分析评分系统）似乎提高了检测的准确性。动脉造影提供的详细解剖信息对于正确解释肾静脉肾素数据至关重要。
