Thomsen H S, Sos T A, Nielsen S L
Department of Diagnostic Radiology, University of Copenhagen, Herley, Denmark.
Acta Radiol. 1989 Mar-Apr;30(2):113-20.
Hypertension constitutes a major health problem and the challenge is to identify patients having 'surgically' curable renal vascular disease among the majority with so-called essential hypertension. The best of unsatisfactory diagnostic tests are renography and plasma renin activity both before and during angiotensin II blockade. The necessity of better screening tests has increased because of the recent advances in surgical techniques and especially percutaneous transluminal renal angioplasty. The latter has definitely become the method of choice for correction of suspected hemodynamically significant artery stenoses whenever technically feasible. With improved angioplasty techniques the risk of treating renal artery stenosis without hemodynamic and clinical importance (so-called cosmetic repair) has increased. Unfortunately randomized trials including surgery versus angioplasty are not available. It should be kept in mind that only after correction of the stenosis is achieved and the blood pressure has become normal, can the diagnosis of renovascular hypertension be made with certainty.
高血压是一个主要的健康问题，面临的挑战是在大多数患有所谓原发性高血压的患者中识别出患有可通过“手术”治愈的肾血管疾病的患者。在血管紧张素 II 阻断之前和期间，肾造影和血浆肾素活性是虽不尽人意但最好的诊断测试。由于外科技术尤其是经皮腔内肾血管成形术的最新进展，对更好的筛查测试的需求增加了。只要技术上可行，后者无疑已成为纠正疑似具有血流动力学意义的动脉狭窄的首选方法。随着血管成形术技术的改进，治疗无血流动力学和临床意义的肾动脉狭窄（所谓的美容修复）的风险增加了。不幸的是，尚无包括手术与血管成形术对比的随机试验。应该记住，只有在实现狭窄纠正且血压恢复正常后，才能确定诊断为肾血管性高血压。
