Dossetor J B, Fam W, Gutelius J R, Turgeon-Knaack C, Morehouse D D
Can Med Assoc J. 1970 Mar 14;102(5):500-4.
Over a 10-year period, positive criteria of the Howard test and the Rapoport Index have shown consistently good correlation with sustained relief or marked improvement in hypertension, in patients with main renal artery lesions. Similar correlation was obtained with ischemic criteria from histopathologic studies.Differential function studies did not reveal positive ischemic criteria in any patient operated upon for unilateral parenchymal disease. Histopathologic criteria of ischemia were also infrequent in this group. Nevertheless, marked improvement or cure of hypertension occurred in 62% of the latter. No factor can be used to predict improvement in this type of renal hypertension. Differential renal function criteria may occasionally appear to indicate renal artery ischemia in the more normal kidney in patients with unilateral parenchymal renal disease; wrong interpretation is avoided by taking differential creatinine clearance into account. Until vasopressor substances can be easily measured and accurately interpreted, aortography is indicated in selected patients.
在10年期间，对于主要肾动脉病变患者，霍华德试验和拉波波特指数的阳性标准一直显示与高血压的持续缓解或显著改善具有良好的相关性。组织病理学研究的缺血标准也得到了类似的相关性。在接受单侧实质性疾病手术的任何患者中，差异功能研究均未发现阳性缺血标准。该组中缺血的组织病理学标准也不常见。然而，后者中有62%的患者高血压得到了显著改善或治愈。没有任何因素可用于预测此类肾性高血压的改善情况。在单侧实质性肾病患者中，差异肾功能标准偶尔可能似乎表明较正常肾脏存在肾动脉缺血；通过考虑肌酐清除率差异可避免错误解读。在能够轻松测量并准确解读血管加压物质之前，建议对选定患者进行主动脉造影。
