Buda J A, Baer L, Parra-Carrillo J Z, Kashef M M, McAllister F F, Voorhees A B, Pirani C L
Arch Surg. 1976 Nov;111(11):1243-8. doi: 10.1001/archsurg.1976.01360290077011.
One hundred sixteen patients underwent operation for renovascular hypertension from 1962 through 1975; 64% had aortorenal reconstruction and 36% had nephrectomy. Sixty-six percent were cured and 19% were improved. Rapid sequence intravenous pyelography, radioisotope renography, and renal arteriography were equal in ability to detect renovascular hypertension. Bilateral renal biopsy specimens had excellent prognostic value when performed in a graded semiquantitative manner. Plasma renin activity was the most consistently useful criterion for prediction of surgical cure if the following requirements were used: (1) elevated peripheral plasma renin activity, (2) elevated renin from the affected kidney, and (3) suppressed renin secretion from the contralateral kidney. An angiotensin II antagonist, saralasin acetate, used in six patients before operation in an attempt to identify those whose hypertension depended on angiotensin II activity, produced a depressor response correlating well with the surgical result.
1962年至1975年间，116例患者接受了肾血管性高血压手术；64%进行了主动脉肾动脉重建术，36%进行了肾切除术。66%的患者治愈，19%的患者病情改善。快速序贯静脉肾盂造影、放射性核素肾造影和肾动脉造影检测肾血管性高血压的能力相当。以分级半定量方式进行双侧肾活检标本具有极佳的预后价值。如果满足以下条件，血浆肾素活性是预测手术治愈最可靠的有用标准：（1）外周血浆肾素活性升高，（2）患侧肾脏肾素升高，（3）对侧肾脏肾素分泌受抑制。术前对6例患者使用血管紧张素II拮抗剂醋酸沙拉新，试图识别那些高血压依赖于血管紧张素II活性的患者，其降压反应与手术结果密切相关。
