卡托普利激发试验在诊断儿童和青少年肾血管性高血压方面的不足。

Inadequacy of captopril challenge test for diagnosing renovascular hypertension in children and adolescents.

作者信息

Gauthier B, Trachtman H, Frank R, Pillari G

机构信息

Schneider Children's Hospital of Long Island Jewish Medical Center, Long Island Campus of Albert Einstein College of Medicine, New Hyde Park, NY 11042.

出版信息

Pediatr Nephrol. 1991 Jan;5(1):42-4. doi: 10.1007/BF00852842.

DOI:10.1007/BF00852842

PMID:2025535

Abstract

A captopril challenge test (CCT) for renovascular disease in adults was described recently. We used it in 20 consecutive, untreated hypertensive children and adolescents. All had a normal urinalysis and glomerular filtration rate and non-diagnostic renal sonograms or intravenous urograms. Plasma renin activity (PRA) was measured before and 1 h after administration of captopril (0.76 +/- 0.17 mg/kg). The CCT was positive in 10 patients. Renal arteriograms were performed in 7 patients with a positive CCT and in 2 with a negative CCT. Renovascular disease was found in 4 patients, 1 of whom had a negative CCT. The PRA response to captopril was the same in patients with true- and the false-positive tests. The predictive value of the positive test was 43%. In conclusion, we did not find the CCT, as described for adults, to be of value in children and adolescents.

摘要

最近描述了一种用于成人肾血管疾病的卡托普利激发试验（CCT）。我们对20名未经治疗的连续性高血压儿童和青少年进行了该试验。所有患者尿常规和肾小球滤过率均正常，肾脏超声或静脉肾盂造影均无诊断意义。在给予卡托普利（0.76±0.17mg/kg）之前及之后1小时测量血浆肾素活性（PRA）。10例患者CCT呈阳性。对7例CCT阳性患者和2例CCT阴性患者进行了肾动脉造影。4例患者发现有肾血管疾病，其中1例CCT为阴性。真阳性和假阳性试验患者对卡托普利的PRA反应相同。阳性试验的预测价值为43%。总之，我们发现如针对成人所描述的CCT对儿童和青少年没有价值。