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许多严重高血压患者用甲巯丙脯酸(captopril)治疗能得到很好控制。本文报道3例无肾动脉狭窄而发生可逆性肾功能衰竭(肾衰)。例1:男性,51岁,有长期应用止痛剂和氯压啶治疗高血压史。高血压眼底Ⅰ级。断层超声与静脉尿路造影快速连续摄片示双侧小肾脏和排泄延迟,无肾动脉狭窄。用甲巯丙脯酸10天后,血肌酐由43升至77mg/L。肾活检示肾小球囊增厚,小叶间动脉增生性粥样硬化。例2:男性,54岁,原发性高血压。高血压眼底Ⅲ级。给予甲巯丙脯酸75mg/d和速尿80mg/d共11天后,血肌酐由55.5升至76mg/L。肾活检光镜
Captopril treatment is well controlled in many hypertensive patients. This article reports 3 cases of renal artery stenosis without reversible renal failure (renal failure). Example 1: Male, 51 years old, with long-term use of analgesics and clonidine for the treatment of hypertension. Hypertensive fundus level Ⅰ. Tomographic ultrasonography and intravenous urography fast continuous radiography showed bilateral small kidney and excretion delay, no renal artery stenosis. After 10 days with captopril, serum creatinine increased from 43 to 77 mg / L. Renal biopsy showed glomerular balloon thickened, interlobular arterial hyperplasia atherosclerosis. Example 2: Male, 54 years old, with essential hypertension. Hypertensive fundus Ⅲ. After giving captopril 75 mg / d and furosemide 80 mg / d for 11 days, serum creatinine increased from 55.5 to 76 mg / L. Kidney biopsy light microscope