Plouin P F, Chatellier G, Guyene T T, Vincent N, Corvol P
Service d'Hypertension, Hôpital Broussais, Paris.
Presse Med. 1989 May 6;18(18):917-21.
Plasma renin activity, angiotensinogen, active renin and aldosterone concentrations and, 1 hour after addition of trypsin 1 mg per ml of plasma at -4 degrees C, prorenin and total renin concentrations were measured in 49 normotensive volunteers. Renin activity and active renin concentration were correlated (n = 98, r = 0.902, p less than 0.01) and their ratio was not dependent on the angiotensinogen concentration. Prorenin accounted for 90 per cent of total renin and was 40 per cent higher in males than in females in both supine and upright positions (p = 0.02 and p = 0.01). The change in position markedly increased plasma renin activity as well as active renin and aldosterone concentrations and, to a lesser degree, prorenin concentration, thereby raising the active/total renin ratio. Plasma renin activity, active renin concentration and plasma aldosterone concentration were significantly and negatively correlated with age, but not with urinary sodium excretion. Plasma renin activity and active renin and angiotensinogen concentrations were also measured in 14 patients with high angiotensinogen concentration (pregnant women and oestrogen users) and in 14 patients with cirrhosis and subnormal angiotensinogen concentration. In these patients the ratio of plasma renin activity to active renin concentration was correlated with the angiotensinogen concentration (n = 28, r = 0.643, p less than 0.01). The slope of the regression line between renin activity and active renin concentration was significantly different in patients with cirrhosis and in healthy volunteers, the measurement of renin activity leading to a ten-fold underestimation of active renin concentration. In clinical investigations of the renin system, plasma samples should be handled at room temperature to avoid cryoactivation of prorenin. The determination of active renin concentration should be preferred to that of plasma renin activity because it is not influenced by physiological or pathological variations in angiotensinogen.
在49名血压正常的志愿者中，测定了血浆肾素活性、血管紧张素原、活性肾素和醛固酮浓度，以及在-4℃下每毫升血浆加入1毫克胰蛋白酶1小时后的肾素原和总肾素浓度。肾素活性与活性肾素浓度相关（n = 98，r = 0.902，p < 0.01），其比值不依赖于血管紧张素原浓度。肾素原占总肾素的90%，在仰卧位和直立位时，男性肾素原均比女性高40%（p = 0.02和p = 0.01）。体位改变显著增加了血浆肾素活性以及活性肾素和醛固酮浓度，在较小程度上也增加了肾素原浓度，从而提高了活性/总肾素比值。血浆肾素活性、活性肾素浓度和血浆醛固酮浓度与年龄显著负相关，但与尿钠排泄无关。还对14名血管紧张素原浓度高的患者（孕妇和使用雌激素者）和14名肝硬化且血管紧张素原浓度低于正常的患者测定了血浆肾素活性、活性肾素和血管紧张素原浓度。在这些患者中，血浆肾素活性与活性肾素浓度的比值与血管紧张素原浓度相关（n = 28，r = 0.643，p < 0.01）。肝硬化患者和健康志愿者中肾素活性与活性肾素浓度之间回归线的斜率显著不同，肾素活性的测定导致活性肾素浓度被低估10倍。在肾素系统的临床研究中，血浆样本应在室温下处理，以避免肾素原的冷激活。活性肾素浓度的测定应优先于血浆肾素活性的测定，因为它不受血管紧张素原生理或病理变化的影响。
