摘要
目的:笔者检测了血压正常的孩子和高血压患儿的肾素-血管紧张素系统(RAS)的活性。试验设计:让27 例高血压患儿(12例肾血管性高血压患儿和15例原发性高血压患儿)和32例血压正常的儿童在一个儿科肾脏病学中心接受检查。血浆肾素活性(PRA)和血管紧张素的肽类血液样本在血压正常的孩子测量1次,高血压患儿治疗前后各测量1次。血浆的萃取是使用联合萃取滤过器(国际通用化学分析法,港口城市,加里福利亚), 肽类浓缩则是用放射免疫测定(RIA)来测定的。结果: PRA,血管紧张素Ⅰ(Ang Ⅰ),血管紧张素Ⅱ(AngⅡ)和血管紧张素-1-7[Ang-(1-7)
Objective We examined the activity of the renin-angiotensin system (RAS) in normotensive and hypertensive children. Study design Hypertensive patients (12 with renovascular hypertension and 15 with essential hypertension) and 32 normotensive subjects were evaluated at a Pediatric Nephr-ology Center. Blood samples for plasma renin activity (PRA) and angiotensin peptides measurements were obtained once from normotensive subjects and before and after treatment from hypertensive patients. Plasma samples were extracted using Bond-Elut cartridges (Analytichem International, Harbor City, Calif), and peptide concentrations were determined by radioimmunoassay (RIA) . Results PRA, Angiotensin Ⅰ (Ang Ⅰ), Angiotensin Ⅱ (Ang Ⅱ), and Angiotensin - (1 - 7) [ Ang - (1 - 7) - ] levels were significantly higher in renovascular hypertensive patients than in normotensive children (3.3 ± 1.2 vs 0.40 ± 0. 22 ng Ang I/mL/hour, 81.4 ± 24. 8 vs 26. 4 ± 13.4 pg/mL, 59.3 ± 17.0 vs 21.4 ± 8.7 pg/mL, 41.0 ± 10. 5 vs 16.2 ± 7. 9 pg/mL, respectively). The surgical treatment normalized blood pressure, PRA, and an-giotensins levels. In contrast with renovascular disease, only Ang - (1 -7) levels were significantly increased in essential hypertensive patients compared with normotensive (78. 8 ± 22. 8 vs 16. 2 ± 7. 9 pg/mL) . Treatment with calcium channel blockers did not alter the RAS measurements. Conclusion Our data show different RAS profiles in childhood hypertension and suggest a blood pressure-independent change of Ang - (1 - 7) in essential hypertension.
