Kutkuhn B, Godehardt E, Kunert J, Torsello G, Grabensee B
Dept. of Nephrology, Heinrich-Heine University, Düsseldorf, FRG.
Clin Exp Hypertens A. 1991;13(2):143-57. doi: 10.3109/10641969109042056.
In order to validate the captopril test for identification of patients with renovascular hypertension (RVH), we performed the test with 118 patients suspected of suffering from RVH who were receiving antihypertensive medication. On the basis of 44 patients with proven RVH and 74 patients with primary hypertension (PH), the sensitivity, specificity and posterior probability for the captopril test were calculated separately for patients undergoing and not undergoing diuretic therapy. An absolute rise in plasma renin activity (PRA) and a relative rise in PRA served as discriminating indicators. The absolute increase of PRA after captopril administration in the absence of long-term therapy with diuretics yielded the best posterior probability in the one-dimensional model, with a sensitivity of 89% and a specificity of 97%. Linking of the variables "absolute" and "relative rise of PRA" reduced the misclassification rate to 5%. This validation allows an accurate distinction between RVH and PH on the basis of the captopril test even when antihypertensive therapy is not suspended (except for ACE inhibitors and diuretics).
为了验证卡托普利试验在识别肾血管性高血压（RVH）患者中的作用，我们对118例正在接受抗高血压药物治疗且疑似患有RVH的患者进行了该试验。根据44例确诊为RVH的患者和74例原发性高血压（PH）患者，分别计算了接受和未接受利尿剂治疗患者的卡托普利试验的敏感性、特异性和后验概率。血浆肾素活性（PRA）的绝对升高和PRA的相对升高作为判别指标。在无利尿剂长期治疗的情况下，卡托普利给药后PRA的绝对增加在一维模型中产生了最佳的后验概率，敏感性为89%，特异性为97%。将“PRA的绝对升高”和“PRA的相对升高”这两个变量联系起来可将错误分类率降至5%。即使不暂停抗高血压治疗（ACE抑制剂和利尿剂除外），这种验证也能使基于卡托普利试验准确区分RVH和PH。
