Greminger P
Departement für Innere Medizin, Medizinische Poliklinik, Universittsspital Zürich.
Schweiz Med Wochenschr. 1996 Jul 27;126(30):1314-20.
The accuracy of various noninvasive screening tests for the detection of renal artery stenosis (urography, duplex scanning, radionuclide scintirenography, intravenous digital subtraction angiography, spiral CT and MR angiography) is discussed. All these methods may show false-negative and false-positive results. Therefore, in the case of a high index of clinical suspicion (i.e. refractory hypertension, recent elevation of serum creatinine, renal dysfunction, asymmetry of kidney size) renal arteriography must be performed. Since the natural history of atherosclerotic and fibrous renal artery stenosis is characterized by progression of the disease with loss of renal function despite good blood pressure control, surgical revascularization or percutaneous angioplasty should be performed whenever possible.
本文讨论了多种用于检测肾动脉狭窄的非侵入性筛查试验（尿路造影、双功扫描、放射性核素闪烁肾造影、静脉数字减影血管造影、螺旋CT和磁共振血管造影）的准确性。所有这些方法都可能出现假阴性和假阳性结果。因此，对于临床怀疑指数较高的情况（即难治性高血压、近期血清肌酐升高、肾功能不全、肾脏大小不对称），必须进行肾动脉造影。由于动脉粥样硬化性和纤维性肾动脉狭窄的自然病史表现为尽管血压控制良好，但疾病仍会进展并导致肾功能丧失，因此应尽可能进行手术血运重建或经皮血管成形术。
