Peters A M, Brown J, Crossman D, Brady A J, Hemingway A P, Roddie M E, Allison D J
Department of Diagnostic Radiology, Hammersmith Hospital, London, England.
J Nucl Med. 1990 Dec;31(12):1980-5.
If a hypertensive patient with renal artery stenosis (RAS) is to benefit from percutaneous transluminal renal angioplasty (PTRA) in terms of a sustained improvement in blood pressure control, one may postulate a demonstrable reduction in renal blood flow (RBF) to that kidney, reversible by PTRA. In a population of 32 hypertensive patients, RAS was present in 23 of 62 kidneys. Eleven of the 32 patients underwent renal revascularization, of whom 6 showed improvement in blood pressure control at 6 mo, i.e., had renovascular hypertension (RVH). There was no correlation between RBF and angiographic appearances of the renal artery. Furthermore, there was no significant difference between RBF in the stenosed kidneys of the patients with RVH compared with the stenosed kidneys of patients without RVH. Individual kidney RBF was 22% (s.d. 11) higher 1-3 wk after PTRA but the increase did not correlate with clinical outcome. Angiotensin converting enzyme (ACE) inhibition increased RBF by 25% (s.d. 25) of baseline flow before PTRA but the increase did not correlate with clinical outcome. Measurement of RBF is of limited value for the prediction of the long-term blood pressure response following PTRA.
如果患有肾动脉狭窄（RAS）的高血压患者要从经皮腔内肾血管成形术（PTRA）中受益，实现血压控制的持续改善，那么可以推测该肾脏的肾血流量（RBF）会有明显减少，且PTRA可使其恢复。在32例高血压患者群体中，62个肾脏中有23个存在RAS。32例患者中有11例接受了肾脏血管重建，其中6例在6个月时血压控制得到改善，即患有肾血管性高血压（RVH）。RBF与肾动脉血管造影表现之间无相关性。此外，RVH患者狭窄肾脏的RBF与无RVH患者狭窄肾脏的RBF之间无显著差异。PTRA后1 - 3周，单个肾脏的RBF高出22%（标准差11%），但这种增加与临床结果无关。血管紧张素转换酶（ACE）抑制使RBF在PTRA前基线流量的基础上增加了25%（标准差25%），但这种增加与临床结果无关。测量RBF对预测PTRA后的长期血压反应价值有限。
