肾血管性高血压为一侧或双侧肾动脉主干或分支狭窄阻塞所造成的高血压。及时解除动脉狭窄或阻塞后,高血压可逆转。它与原发性高血压合并肾动脉阻塞或肾硬化不同,后者系长期高血压的后果,即使解除阻塞也不能使血压复原。一、病理生理:本病过程分为三期,第一期常在动物实验中见到,肾动脉被钳央数分钟后发现,血压升高与循环中肾素及血管紧张素Ⅱ升高相平行,反映血压升高是由于周围血管紧张素Ⅱ增高所致。当钳夹解除后,血浆肾素、血管紧张素Ⅱ及血压很快恢复正常水平。若钳夹肾动脉持续数天或数周则进入第二期,此时血压升高,但循环中肾素及血管紧张素Ⅱ则无明显增高,至少高血压与肾素-血管紧张素系统的刺激呈部份分离,但血管紧张素Ⅱ仍可能是重要的发病因素,故此期纠正肾动脉狭窄或肾切除后高血压仍可缓解。在少数患者及动物实验中发现,单侧肾动脉重度狭窄引起肾素、血管紧张素Ⅱ、醛固酮及血压均明显增高,钠及钾丢失,这是低血钠性高血压综合征.若第二期未发展到严重低血钠性综合征,将经过数月成 Renal vascular hypertension is caused by obstruction of one or both of the main renal artery or branch of the narrow hypertension. Timely lifting of the artery stenosis or obstruction, hypertension can be reversed. It is associated with essential hypertension with renal artery obstruction or renal sclerosis, which is the result of long-term high blood pressure, even if the lifting of the obstruction can not make blood pressure recovery. First, the pathophysiology: The disease process is divided into three phases, the first phase often seen in animal experiments, the renal artery clamp was found a few minutes later found that blood pressure and circulating renin and angiotensin Ⅱ phase Parallel, reflecting elevated blood pressure is due to increased peripheral angiotensin Ⅱ. When the clamp was released, plasma renin, angiotensin Ⅱ and blood pressure quickly returned to normal levels. If the clamp renal artery for several days or weeks then enter the second phase, when blood pressure, but the cycle of renin and angiotensin II was no significant increase in at least hypertension and renin - angiotensin system Stimulation was partially isolated, but angiotensin Ⅱ may still be an important risk factor, so the period of renal artery stenosis or nephrectomy can still relieve hypertension. In a small number of patients and animal experiments found that severe narrow unilateral renal artery caused by renin, angiotensin II, aldosterone and blood pressure were significantly increased, sodium and potassium loss, which is hyponatremia .If the second Not developed to severe hyponatremia syndrome, will be after several months into