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体外震波碎石术(ESWL)治疗肾结石后,约8％的患者可发生高血压。关于ESWL与高血压的关系,目前存在两种看法:(1)ESWL为高皿压的发生原因;(2)高血压为年龄依赖性自然发生,与ESWL无关。关于前一种看法,Williams和Eurturk提出了ESWL后paqe肾高血压的发病机理为:肾包膜下血肿→肾实质受压→肾血灌流减少→肾缺血→肾素(RA)释放增加→血管紧张素(AⅡ)产生增多→,血管收缩和继发钠水潴留→高血压形成。在此看法中,肾素(RA)—血管紧张素(AⅡ)—醛固酮(ALD)系统是paqe肾高血压的主要参与者,我们假设ESWL后高血压的发生机理的确是由于paqe肾形成,并对肾结石患者ESWL治疗前后血浆中RA、AⅡ及ALD进行检测,来进一步探讨ESWL是否为高血压的发生原因。
After extracorporeal shock wave lithotripsy (ESWL) is used to treat kidney stones, about 8% of patients develop hypertension. There are currently two perspectives on the relationship between ESWL and hypertension: (1) ESWL is the cause of BPH; and (2) hypertension is age-dependent and occurs independently of ESWL. In the former opinion, Williams and Eurturk proposed the pathogenesis of paqe renal hypertension following ESWL as follows: subrenal hematoma → renal parenchymal pressure → reduced renal blood flow perfusion → renal ischemia → increased release of renin (RA) → Angiotensin (A Ⅱ) increased production →, vasoconstriction and secondary sodium and water retention → hypertension. In this view, the renin (RA) -AII-aldosterone (ALD) system is a major contributor to paqe renal hypertension, and we hypothesized that the pathogenesis of post-ESWL hypertension is indeed due to paqe kidney formation and ESWL in patients with kidney stones before and after treatment of plasma RA, A Ⅱ and ALD were detected to further explore whether ESWL is the cause of hypertension.