高血压和慢性肾衰竭患者的卡托普利肾闪烁显像

Captopril renal scintigraphy in patients with hypertension and chronic renal failure.

作者信息

Datseris I E, Bomanji J B, Brown E A, Nijran K S, Padhy A K, Siraj Q H, Britton K E

机构信息

Department of Nuclear Medicine, St. Bartholomew's Hospital, London, England, UK.

出版信息

J Nucl Med. 1994 Feb;35(2):251-4.

PMID:8294993

Abstract

UNLABELLED

The aim of this prospective study was to determine the ability of the captopril renogram to reveal the presence of angiotensin II-dependent renovascular disorder in hypertensive patients with chronic renal failure and to assess the possibility of predicting beneficial effect of angiotensin-converting enzyme (ACE) inhibitors on renal function.

METHODS

Forty-one patients were evaluated. Baseline renal scintigraphy was performed with 80 MBq of 99mTc-mercaptoacetyltriglycine (MAG3) injected intravenously. Scintigraphy was repeated within a week with 25 mg of oral captopril given 60 min prior to the test. Using the measurements outlined by the Working Party on Diagnostic Criteria of Renovascular Hypertension with Captopril Renography, the patients were categorized into high (7 patients), indeterminate (19 patients) and low (15 patients) probability for renal artery stenosis (RAS).

RESULTS

In five of the seven patients with high probability, the presence of RAS was confirmed angiographically and corrective surgical procedure performed in two. In patients with GFR of 10 ml/min/1.73 m2 and/or split renal function of 10% or less, all qualitative and semiquantitative scintigraphic parameters were nonspecific. Mean parenchymal transit time of tracer was a useful parameter to predict the beneficial effect of ACE inhibition therapy in 23 patients (14 low and 9 indeterminate probability of RAS).

CONCLUSION

In hypertensive patients with renal failure, captopril renal scintigraphy can be utilized to identify the presence of angiotensin II-dependent renal dysfunction and possibly help to predict the beneficial effect of ACE inhibitor therapy.

摘要

未标注

本前瞻性研究的目的是确定卡托普利肾图显示慢性肾衰竭高血压患者中存在血管紧张素 II 依赖性肾血管疾病的能力，并评估预测血管紧张素转换酶（ACE）抑制剂对肾功能有益作用的可能性。

方法

对 41 名患者进行了评估。基线肾闪烁显像采用静脉注射 80MBq 的 99mTc-巯基乙酰三甘氨酸（MAG3）。在测试前 60 分钟口服 25mg 卡托普利，一周内重复进行闪烁显像。根据肾血管性高血压诊断标准工作小组制定的卡托普利肾图测量方法，将患者分为肾动脉狭窄（RAS）高概率组（7 例）、不确定组（19 例）和低概率组（15 例）。

结果

在 7 例高概率患者中，有 5 例经血管造影证实存在 RAS，其中 2 例进行了矫正手术。在肾小球滤过率（GFR）为 10ml/min/1.73m2 和/或分肾功能为 10%或更低的患者中，所有定性和半定量闪烁显像参数均无特异性。示踪剂的平均实质通过时间是预测 23 例患者（14 例低概率和 9 例 RAS 不确定概率）ACE 抑制治疗有益效果的有用参数。