比较开搏通与氯沙坦在同位素肾显像中诊断肾动脉狭窄的作用

Comparison of Losartan Isotope Renography and Captopril Isotope Renography in the Diagnosis of Renal Artery Stenosis

目的 比较开搏通肾显像和氯沙坦肾显像诊断肾动脉狭窄的作用。病例和方法 2 0 0 0年 10月至 2 0 0 1年 12月 ,共 4 6例疑诊肾血管性高血压的住院患者 ,先行开搏通肾同位素显像 ,2 4小时后行氯沙坦同位素肾显像。所有可疑肾动脉狭窄患者在肾显像后 7天内行肾动脉造影。结果 肾动脉造影显示共 92个肾脏中 6 7个肾脏的肾动脉无明显狭窄 ,另 2 5个肾脏的肾动脉直径狭窄≥ 5 0 %。开搏通肾显像和氯沙坦肾显像诊断肾动脉狭窄的敏感性分别为6 0 0 %和 84 0 % ,特异性分别为 95 5 %和 97 0 % ,准确性分别为 85 8%和 93 4 %。后者诊断的敏感性和准确性显著高于前者 (P <0 0 5 )。结论 氯沙坦肾显像诊断肾动脉狭窄的敏感性和准确性明显高于开搏通肾显像。

Objectives To compare the accuracy of losartan isotope renography with captopril Isotope renography in the diagnosis of renal artery stenosis. Methods Forty-six hospitalized patients with suspected renovascular hypertension were underwent captopril isotope renography, then losartan isotope renography 24 hours later. Within 7 days after radionuclide renography study, renal artery angiography was performed to confirm the diagnosis. Results The renoangiography showed renal artery diameter reduction ≥50% in 25 kidneys, and no significant stenosis in the 67 kidneys. The sensitivity, specificity and accuracy of captopril and losartan isotope renography for diagnosing critical renal artery stenosis were 60.0% versus 84.0%(P<0.05), 95.5% versus 97.0%(P>0.05), and 85.8% versus 93.4%(P<0.05), respectively. Conclusion Losartan isotope renography has a higher sensitivity and accuracy in diagnosis of renal artery stenosis than that by captopril isotope renography.