卡托普利肾动态显像对肾动脉狭窄的诊断价值

Diagnostic Value of Captopril Renography in Identification of Renal Artery Stenosis

目的:探讨卡托普利肾动态显像(肾显像)对肾动脉狭窄的诊断价值。方法:回顾分析1993年～2007年我院临床确诊大动脉炎且怀疑有肾动脉受累的110例患者的临床资料。110例患者中男性25例,女性85例,平均年龄为(30.2±10.7)岁。所有患者均进行了肾动脉造影和卡托普利肾显像,并将最终结果分为肾动脉造影正常组(肾动脉无狭窄者,n=33)及肾动脉造影异常组(肾动脉狭窄者,n=77)进行统计分析。结果:肾动脉造影证实77例有肾动脉狭窄(≥50%),其中双侧肾动脉狭窄者40例,单侧肾动脉狭窄37例。肾动脉造影异常组的77例肾动脉狭窄患者,73例卡托普利肾显像阳性;肾动脉造影正常组的33例中30例卡托普利肾显像阴性。卡托普利肾显像诊断大动脉炎性肾动脉狭窄的敏感性、特异性和准确性分别为94.8%、90.9%和93.6%。卡托普利肾显像诊断单侧肾动脉狭窄的敏感性为94.6%,诊断双侧肾动脉狭窄敏感性为95.0%。110例患者共220支肾动脉,117支肾动脉造影有狭窄病变,其中104支卡托普利肾显像阳性;103支无明显狭窄的肾动脉中,94支卡托普利肾显像阴性。卡托普利肾显像判断血管病变的敏感性、特异性和准确性分别为88.9%、91.3%和90.0%。结论:卡托普利肾显像与肾动脉造影比较对大动脉炎患者肾动脉狭窄有较高的诊断价值,卡托普利肾显像可作为大动脉炎是否累及肾动脉病变的一种无创性筛选诊断方法。

Objective：To evaluate the value of captopril renography in identification of renal artery stenosis in Aortoarteritis. Methods： One hundred and one patients with Aortoarteritis undergoing captopril renography were retrospectively analyzed. All patients also received renal artery angiography within 2 weeks of captopril renography. Results： Among the patients, there were 25 males and 85 females. The mean age was 30.2±10. 7 years old. Seventy-seven patients had angiographic renal artery stenosis. Of them, 40 had bilateral renal artery stenosis and 37 had unilateral renal artery stenosis. The sensitivity, specificity and accuracy of captopril renography was 94. 8% , 90. 9 % and 93. 6% for diagnosing renal artery stenosis, and 88. 9% , 91.3% and 90. 0% for the number of diseased vessels. Conclusion ： Captopril renography is a safe and accurate method for detection of renal artery stenosis in patients with Aortoar-teritis.