Takata M, Yoshida K, Tomoda F, Oh-hashi S, Ueno H, Yasumoto K, Iida H, Sasayama S
Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.
Angiology. 1994 Mar;45(3):181-6. doi: 10.1177/000331979404500302.
To examine the utility of the single-dose captopril test in detecting renovascular hypertension (RVHT), the authors measured peripheral plasma renin activity (PRA), before and thirty and sixty minutes after an oral dose of captopril (25 mg), in 28 patients with RVHT and 22 patients with high-renin essential hypertension (EHT) without renal artery stenosis who were consuming 8 grams of sodium chloride per day. There was considerable overlap of individual values in basal PRA between the two groups. Sixty minutes after captopril, PRA was higher in RVHT than in EHT patients (74.8 +/- 63.9 versus 15.1 +/- 11.9 ng/mL/hr, P < 0.01). With the cutoff point set at 16 ng/mL/hr, RVHT was detected with a sensitivity of 96% and a specificity of 77%. The discriminating power was also superior to that based on blood pressure response to angiotensin II analogue under sodium depletion, rapid-sequence intravenous pyelography, or renography. These results show that captopril-stimulated peripheral PRA is an adequate screening tool for detecting RVHT in a population with high-renin hypertension.
为研究单剂量卡托普利试验在检测肾血管性高血压（RVHT）中的效用，作者测量了28例RVHT患者和22例高肾素性原发性高血压（EHT）且无肾动脉狭窄、每日摄入8克氯化钠患者口服一剂卡托普利（25毫克）前、服药后30分钟及60分钟时的外周血浆肾素活性（PRA）。两组间基础PRA的个体值有相当大的重叠。卡托普利给药60分钟后，RVHT患者的PRA高于EHT患者（74.8±63.9对15.1±11.9纳克/毫升/小时，P<0.01）。将临界值设定为16纳克/毫升/小时时，检测RVHT的灵敏度为96%，特异性为77%。其鉴别能力也优于基于钠缺失情况下对血管紧张素II类似物的血压反应、快速序列静脉肾盂造影或肾造影的鉴别能力。这些结果表明，卡托普利刺激的外周PRA是检测高肾素性高血压人群中RVHT的一种合适筛查工具。
