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目前对双侧性肾血管高血压症的治疗尚无一定标准,虽然有报告用血管紧张素转换酶抑制剂治疗单侧肾血管性高血压有效。但对双侧肾血管高血压的疗效不确切。本文报告1例21岁女性,血压为160/110mmHg,18岁时为140/100mmHg,1年后收缩期血压至180mmHg 以上。开始时应用利尿降压药无效,1年后改用甲基多巴半年后因肝脏损害停服。体检发现腹部(左上腹)有血管杂音。血浆肾素活性检查显著高值(安静时4ng/ml/h,正常值0.5～2.1ng/ml/h)。虽然 RI 肾图及肾脏超声图均未见左右肾脏大小差异,后用迅速连续静脉肾盂造影可见左侧输尿管有切迹,并见反相高浓度征(paradoxieal hypefconcen-
There is currently no standard for the treatment of bilateral renal hypertension, although there are reports of angiotensin-converting enzyme inhibitors for the treatment of unilateral renal vascular hypertension. However, the efficacy of bilateral renal vascular hypertension is not exact. This article reports a 21-year-old female with a blood pressure of 160/110 mm Hg, 140/100 mmHg at 18 years of age and systolic blood pressure above 180 mm Hg after 1 year. The beginning of the application of diuretic antihypertensive drugs ineffective, 1 year after the switch to methyl dopamine six months after stopping due to liver damage. Physical examination found abdominal (left upper quadrant) vascular murmur. Plasma renin activity was significantly higher (4 ng / ml / h at rest, normal 0.5 to 2.1 ng / ml / h). Although there was no difference in kidney size between the RI kidney map and the renal ultrasound map, rapid retroperitoneal pyelography revealed a notch on the left ureter and a paradoxieal hypefconcen- tation