Ideishi M, Takii M, Hiroki T, Arakawa K
Jpn Heart J. 1978 Jan;19(1):151-8. doi: 10.1536/ihj.19.151.
A case of accelerated hypertension, which was unique in a resistance to an angiotensin antagonist, and a lack of the elevation of plasma renin activity (PRA) is reported. Non-elevated PRA was coincided with non-malignant nephrosclerosis in renal histology. The acceleration was attributed to the neurological cause i.e., cerebral hemorrhage in the right hypothalamus which extended to the ventricle and subarachnoid space. The case therefore clinically seemed malignant-like, but it was not malignant hypertension in the sense of Volhard's classical definition. This does not conflict with the usefulness of the determination of PRA in the diagnosis of malignant hypertension with nephrosclerosis.
报告了一例加速性高血压病例，该病例的独特之处在于对血管紧张素拮抗剂耐药，且血浆肾素活性（PRA）未升高。PRA未升高与肾脏组织学中的非恶性肾硬化症相符。病情加速归因于神经学原因，即右下丘脑脑出血并延伸至脑室和蛛网膜下腔。因此，该病例临床上看似恶性高血压，但从Volhard经典定义的意义上来说并非恶性高血压。这与测定PRA在诊断伴有肾硬化症的恶性高血压中的作用并不矛盾。
