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分析[J].中国医学影像技术,2020,36(3):
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分析
Analysis of the influence of plasma renin activity on captopril renal scintigraphy in the diagnosis of renovascular hypertension
投稿时间:2019-07-23  修订日期:2020-03-16
DOI:
中文关键词:  肾血管性高血压  肾动态显像  卡托普利  RAAS系统
英文关键词:: Renal vascular hypertension  Renal scintigraphy  Captopril  Renin-angiotensin-aldosterone system
基金项目:2013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) rxm1126@163.com 
段莉莉 郑州大学人民医院(河南省人民医院)  
武新宇 郑州大学人民医院(河南省人民医院)  
王鹏 郑州大学人民医院(河南省人民医院)  
徐俊玲 郑州大学人民医院(河南省人民医院)  
高永举* 郑州大学人民医院(河南省人民医院) gyongju@163.com 
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中文摘要:
      目的 研究卡托普利肾动态显像(CRS)诊断肾血管性高血压(RVH)及血浆肾素活性(PRA)对其诊断敏感性的影响,以提高CRS的应用价值。方法 回顾性分析RVH患者35例,均行卧、立位外周血浆PRA、AngII、ALD水平检测及基础、卡托普利肾动态显像(CRS)。按CRS结果分为阳性组(24例)及阴性组(11例)。采用非参数Mann-Whitney U检验比较两组激素水平,ROC曲线分析两组血浆立位PRA,得出PRA的最低阈值。结果 阳性组立位PRA较阴性组显著升高(Z=3.11,P=0.00);两组卧位PRA 、立卧位AngII及ALD均无统计学意义(Z=1.92,P=0.07;Z=0.73,P=0.47;Z=0.55,P=0.59;Z=1.32,P=0.20;Z=0.29,P=0.80)。ROC曲线分析两组立位PRA,结果示曲线下面积为0.84,PRA为2.47ng.ml-1.h-1时,CRS诊断RVH阳性的敏感度为83.33%,特异度为81.82%。结论 RVH患者立位PRA是影响CRS诊断敏感性的重要指标,应用CRS时联合血浆PRA测定,可以提高CRS在RVH诊疗中的应用价值。
英文摘要:
      Objective To study captopril renal scintigraphy (CRS) in the diagnosis of renovascular hypertension (RVH) and analysis the effect of plasma renin activity (PRA), in order to improve the application value of CRS. Methods The plasma levels of PRA, AngII and ALD in peripheral blood of 35 patients with RVH were analyzed retrospectively, and performed a basic renal scintigraphy and CRS examination. According to the results, they were divided into positive group (n=24) and negative group (n=11). The levels of PRA, AngII and ALD were analyzed by nonparametric Mann-Whitney U test, and PRA by ROC curve for the minimum threshold, respectively. Result The orthostatic position of PRA in positive group was significantly higher than that in negative group (Z=3.11,p=0.00). The supine position of PRA, supine and orthostatic position AngII and ALD were not statistically significant in two groups (Z=1.92, P=0.07; Z=0.73, P=0.47; Z=0.55, P=0.59; Z=1.32, P=0.20; Z=0.29, P=0.80, respectively). With ROC curve analysis of two groups of orthostatic position PRA, the results showed that the area under the curve is 0.84. When the threshold point of PRA was 2.47 ng?ml-1?h-1, the sensitivity and specificity respectively were 83.33% and 81.82%. Conclusion PRA in orthostatic position of RVH patients is an important index influencing diagnostic sensitivity of CRS. Combined with orthostatic position plasma PRA, the value of CRS for diagnosis and treatment of RVH can be improved.
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