腎血管性高血圧症の手術前後における1-Sarcosine, 8-Isoleucine Angiotensin II検査の臨床的意義

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Recently, some angiotensin II analogues have been reported as competitive inhibitors for angiotensin II in renin dependent hypertension. 1-Sar, 8-Ile, angiotensin II, which is reported to have the strongest action among the angiotensin II analogues, was administrated, pre-and post-operatively, to 3 cases of renovascular hypertension, one case of hypertension due to remarkable unilateral hydronephrosis, malignant hypertension and hypertension with chronic glomerulonephritis. In this article, we designed to study the relationship between the kinds of hypertension related to plasma renin activity and response of blood pressure to 1-Sar, 8-Ile, angiotensin II, and to study whether this drug is used as a diagnostic aid or for decision of operative indication for renovascular hypertension. Under non-limited diet, or low-salt (NaCl : under 3.0g per day) diet and furosemide 120 mg per day for 3 days, 1-Sar, 8-Ile, angiotensin II was administrated, dissolved in normal saline. When the blood pressure was decreased more over than 20mmHg systolic or 10mmHg diastolic by this drug, the response was judged to be positive, Two cases of renovascular hypertension, which had high peripheral plasma renin activity and lateralizing renal vein renin ratio, showed positive response to 1-Sar, 8-Ile, angiotensin II. The rest 2 cases of renovascular hypertension, of which one had high peripheral plasma renin activity increasing into abnormal high range by stimmulation, showed a positive blood pressure response after decreasing of total plasma volume by low-salt diet and furosemide administration, though they presented a negative blood pressure response under normal diet or normal condition.
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腎血管性高血圧症の手術前後における1-Sarcosine, 8-Isoleucine Angiotensin II検査の臨床的意義

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