阮谢妹,段莉莉,武新宇,王鹏,徐俊玲,高永举.卡托普利肾动态显像诊断肾血管性高血压及血浆肾素的影响[J].中国医学影像技术,2020,36(3):387~390
卡托普利肾动态显像诊断肾血管性高血压及血浆肾素的影响
Captopril renal scintigraphy in diagnosis of renovascular hypertension and the impact of plasma renin activity
投稿时间:2019-07-23  修订日期:2019-12-20
DOI:10.13929/j.issn.1003-3289.2020.03.016
中文关键词:  高血压,肾性  卡托普利  肾素-血管紧张素系统  放射性核素显像
英文关键词:hypertension,renal  Captopril  renin-angiotensin system  radionuclide imaging
基金项目:国家临床重点专科建设项目(2013-544)。
作者单位E-mail
阮谢妹 郑州大学人民医院 河南省人民医院核医学科, 河南 郑州 450003  
段莉莉 郑州大学人民医院 河南省人民医院核医学科, 河南 郑州 450003  
武新宇 郑州大学人民医院 河南省人民医院核医学科, 河南 郑州 450003  
王鹏 郑州大学人民医院 河南省人民医院核医学科, 河南 郑州 450003  
徐俊玲 郑州大学人民医院 河南省人民医院核医学科, 河南 郑州 450003  
高永举 郑州大学人民医院 河南省人民医院核医学科, 河南 郑州 450003 gyongju@163.com 
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中文摘要:
      目的 探讨卡托普利肾动态显像(CRS)诊断肾血管性高血压(RVH)的效能及血浆肾素活性(PRA)的影响。方法 回顾性分析35例接受立、卧位外周血浆PRA、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)水平检测及基础、CRS的RVH患者,按CRS结果分为阳性组和阴性组。比较2组激素水平,以ROC曲线分析2组血浆立位PRA,得出PRA的最低阈值。结果 阳性组24例,阴性组11例。阳性组立位PRA较阴性组升高(Z=3.11,P<0.001);2组卧位PRA、立卧位AngⅡ及ALD差异均无统计学意义(P均>0.05)。ROC曲线分析显示2组立位PRA的AUC为0.84,PRA为2.47 ng/(ml·h)时,CRS诊断RVH阳性的灵敏度为83.33%,特异度为81.82%。结论 立位PRA是影响CRS诊断RVH敏感度的重要因素。联合测定血浆PRA可提高CRS对RVH的诊断效能。
英文摘要:
      Objective To observe the diagnostic efficiency of Captopril renal scintigraphy (CRS) for renovascular hypertension (RVH) and the impact of plasma renin activity (PRA). Methods Plasma levels of PRA, angiotensin Ⅱ (AngⅡ) and aldosterone (ALD) in peripheral blood in orthostatic position and supine position of 35 RVH patients who underwent basic renal scintigraphy and CRS examination were retrospectively analyzed. According to CRS, the patients were divided into positive group and negative group. The levels of PRA, AngⅡ and ALD were analyzed. ROC curve was used to analyze PRA and obtain the minimum threshold. Results There were 24 cases in positive group and 11 cases in negative group. The orthostatic position PRA in positive group was significantly higher than that in negative group (Z=3.11,P<0.001). The supine position PRA, supine and orthostatic position AngⅡ and ALD were not statistically different between two groups (all P>0.05). ROC curve analysis showed that the area under the curve was 0.84. When the threshold point of PRA was 2.47 ng/(ml·h), the sensitivity and specificity were 83.33% and 81.82%, respectively. Conclusion Orthostatic position PRA is an important impact factor of diagnostic sensitivity of CRS for RVH. Combining with orthostatic position plasma PRA can improve the value of CRS for diagnosis and treatment of RVH.
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