Roubidoux M A, Dunnick N R, Klotman P E, Newman G E, Cohan R H, Kadir S, Svetkey L P
Department of Radiology, Duke University Medical Center, Durham, NC 27710.
Radiology. 1991 Mar;178(3):819-22. doi: 10.1148/radiology.178.3.1994424.
To determine whether the captopril-stimulated renal vein renin ratio (CSRVRR) could enable identification of patients with hemodynamically significant renovascular lesions who would respond to revascularization, the authors measured CSRVRRs in 143 consecutive patients with hypertension who had been selected because of clinical features suggestive of renovascular hypertension. All patients underwent conventional renal arteriography. Renovascular hypertension was the final diagnosis if revascularization resulted in cure or improvement in blood pressure. Complete data were available for 133 patients. Twenty patients had renovascular hypertension; CSRVRR was greater than 1.5 in 13 of these 20 patients (sensitivity, 65%). However, it was also greater than 1.5 in 54 of the 113 patients without renovascular hypertension (false-positive rate, 47.8%). The positive predictive value of CSRVRR was 18.6%; the negative predictive value, 89.3%. It is concluded that CSRVRR is not sufficiently sensitive to enable prediction of which patients will respond to revascularization and is not specific enough to exclude patients who do not have renovascular hypertension.
为了确定卡托普利刺激后的肾静脉肾素比值（CSRVRR）能否用于识别那些对血管重建有反应的、具有血流动力学显著意义的肾血管病变患者，作者对143例因临床特征提示肾血管性高血压而入选的连续性高血压患者测量了CSRVRR。所有患者均接受了传统的肾动脉造影。如果血管重建导致血压治愈或改善，则最终诊断为肾血管性高血压。133例患者有完整的数据。20例患者患有肾血管性高血压；这20例患者中有13例的CSRVRR大于1.5（敏感性为65%）。然而，在113例无肾血管性高血压的患者中，也有54例的CSRVRR大于1.5（假阳性率为47.8%）。CSRVRR的阳性预测值为18.6%；阴性预测值为89.3%。结论是，CSRVRR的敏感性不足以预测哪些患者会对血管重建有反应，特异性也不足以排除没有肾血管性高血压的患者。
