Kuchel O, Messerli F H, Tolis G, Hamet P, Fraysse J, Cartier P, Roy P, Boucher R, Genest J
Can Med Assoc J. 1977 May 7;116(9):992-6.
The concentration of plasma adenosine 3',5'-cyclic monophosphate (cyclic AMP) and plasma renin activity (PRA) were measured concomitantly in blood from both renal veins and in arterial blood in 22 hypertensive patients. In the nine patients with true renovascular hypertension the concentration of plasma cyclic AMP was greater in the venous effluent of the kidney affected by the renal artery stenosis than in that of the unaffected or less affected kidney. The arteriovenous difference in cyclic AMP concentration was less on the affected side in all but one patient. The arteriovenous differences in PRA identified the affected kidney as the source of hyper-reninemia and showed that renin release from the other kidney was suppressed. In the 13 patients with hypertension associated with but unrelated to renal artery stenosis there were no consistent patterns of cyclic AMP concentration or PRA in the venous effluent of the kidneys or of their arteriovenous differences. In renovascular hypertension the venous effluent of the kidney affected by renal artery stenosis contains not only more renin but also more cyclic AMP, owing to either increased cyclic AMP production or decreased excretion or extraction of cyclic AMP by the affected kidney. This unilateral increase in cyclic AMP concentration may become a complementary diagnostic feature of true renovascular hypertension.
在22例高血压患者中，同时测定了双侧肾静脉血和动脉血中的血浆3',5'-环磷酸腺苷（环磷腺苷）浓度及血浆肾素活性（PRA）。在9例真性肾血管性高血压患者中，受肾动脉狭窄影响的肾脏静脉流出液中的血浆环磷腺苷浓度高于未受影响或受影响较小的肾脏。除1例患者外，患侧环磷腺苷浓度的动静脉差值均较小。PRA的动静脉差值确定患侧肾脏是高肾素血症的来源，并表明另一侧肾脏的肾素释放受到抑制。在13例与肾动脉狭窄相关但无关的高血压患者中，肾脏静脉流出液中的环磷腺苷浓度或PRA及其动静脉差值没有一致的模式。在肾血管性高血压中，受肾动脉狭窄影响的肾脏静脉流出液不仅含有更多的肾素，还含有更多的环磷腺苷，这可能是由于患侧肾脏环磷腺苷生成增加，或环磷腺苷排泄或摄取减少所致。这种环磷腺苷浓度的单侧升高可能成为真性肾血管性高血压的一个补充诊断特征。
