Lee S M, Drach G W
J Urol. 1980 Nov;124(5):704-6. doi: 10.1016/s0022-5347(17)55618-9.
We report a case of severe hypertension in a girl with no evidence of parenchymal renal disease. Arteriography revealed segmental stenosis and a saccular aneurysm affecting a branch of the left renal artery. Segmental renal vein renin sampling demonstrated a markedly increased rate of renin secretion from the ischemic portion of the left kidney. Partial nephrectomy resulted in normalization of the blood pressure. The resected kidney showed striking hyperplasia of the juxtaglomerular apparatus and medial fibromuscular dysplasia as the etiology of the arterial stenosis. This case emphasizes the value of segmental renin vein sampling in the evaluation of pediatric hypertension and illustrates the high cure rate obtained by surgical correction.
我们报告一例无实质性肾病证据的女孩严重高血压病例。动脉造影显示节段性狭窄和一个影响左肾动脉分支的囊状动脉瘤。节段性肾静脉肾素采样显示左肾缺血部分的肾素分泌率显著增加。部分肾切除术使血压恢复正常。切除的肾脏显示肾小球旁器显著增生和内侧纤维肌发育异常，这是动脉狭窄的病因。该病例强调了节段性肾静脉采样在评估儿童高血压中的价值，并说明了手术矫正可获得较高的治愈率。
