高能冲击波束聚焦碎石术后高血压的临床研究

Clinical investigation of hypertension following high energy shock－ wave lithotripsy

目的探讨体外震波碎石术（ ESWL）后出现新的高血压及其可能的原因。方法检测部分患者的血浆肾素（ PR）－血管紧张素 II（ AII）系统活性、前列环素（ PGI2）和血栓素 A2（ TXA2）的浓度。结果术后高血压者所接受的震波次数、血浆 PR－ AII系统活性及 TXA2浓度明显高于血压正常者，而其血浆 PGI2的浓度则明显低于血压正常者。结论 ESWL后新的高血压可能的原因是高能冲击波导致肾脏损伤、缺血，刺激血浆 PR－ AII系统活性升高，而 TXA2合成增多、 PGI2合成减少使血管壁对缩血管物质的敏感性增强。

Objective Discuss whether there are new hypertension following extracorporeal shock wave lithotripsy(ESWL) and its possible reason. Methods Determinate the activity level of Plasma Renin(PR)－ Angiotension II(AII), Prostacyclin(PGI2) and Thromboxane A2(TXA2).Analysis the relationship between hypertension and shock wave. Results The levels of PR, AII and TXA2 of the patients with hypertension after ESWL were significantly higher than that of the patients with normotension. The levels of PGI2 were just contraverse. It was showed by statistics that there is a significantly relationship between the hypertension and shock wave. Conclusion The possible reason is that injure of the kidney by high energy shock wave results in ischemia in the kidney and irritates the kidney to release more renin and AII . Meanwhile, increased concentration of TXA2 and decreased PGI2 make the vessle walls more sensitive to AII.