Meyrier A, Rainfray M, Lacombe M
Service de Néphrologie et d'Hémodialyse, Hôpital Avicenne, Bobigny, France.
Am J Nephrol. 1988;8(2):108-11. doi: 10.1159/000167567.
Severe hypertension developed in 4 patients who had sustained blunt renal trauma 2-32 years previously. A protracted period of normal blood pressure separated the renal injury from the onset of hypertension. Angiography disclosed lesions which had been underestimated by intravenous pyelography. These lesions consisted of traumatic dissection of branches of the renal artery, leading to renal infarct. In 3 cases, unilateral high renin secretion was demonstrated, and in 1 case this was confirmed by immunofluorescence with an anti-renin antiserum which showed abundant renin granules within the infarcted zone. In all patients, total or polar nephrectomy was followed by return of blood pressure to normal or near-normal levels. Blunt renal trauma is an underestimated cause of renovascular hypertension.
4例患者在2至32年前遭受钝性肾外伤后出现严重高血压。肾损伤与高血压发作之间有一段血压正常的漫长时期。血管造影显示的病变被静脉肾盂造影低估。这些病变包括肾动脉分支的创伤性夹层，导致肾梗死。3例显示单侧高肾素分泌，1例通过抗肾素抗血清免疫荧光证实，梗死区内可见大量肾素颗粒。所有患者行全肾或肾极切除术血压均恢复正常或接近正常水平。钝性肾外伤是肾血管性高血压的一个被低估的病因。
