Korean Journal of Nephrology 1991;10(4):545-554.

신혈관성 고혈압에서 Angiotensin Converting Enzyme Inhibitor를 이용한 신 Scan의 기능평가의 의의

채동완 , 안규리 , 한진석 , 김성권 , 이정상

Abstract

We performed Tc-DTPA renal scintigraphy before (basal scintigraphy) and after (captopril scintigraphy) oral administration of 25 mg captopril and renal angiography in 34 patients who were clinically suspected of having renovascular hyper- tension (RVH). There were 13 non-renovascular hypertension (NRVH), 12 unilateral renovascular hypertension (URVH) and 9 bilateral renovascular hypertension (BRVH). Findings in basal scintigra- phy remained unchanged in all NRVH patients except one patient whose change was thought to be non-specific due to a volume factor. While there were no captopril-induced changes in RVH patients with flattened renal time-activity curves in basal scintigraphy, time-activity curves showed flattening or decreased peak activity or delayed peak time or both in all RVH patients with basal scintigraphy normal or suggestive of renal dysfunction, PAR in NRVH, RVH, URVH, and BRVH were -1.4± 2.1/p, 8.8± 7.1%, 10.5± 2.9%, and 7.2±9.0%respectively and Dtmax in NRVH, RVH, URVH, and BRVH were 36.9±30.14sec, 571. 1±433.2sec, 575.0±504.2sec, and 567.7±390.8sec, respectively.PAR and Dtmax were greater in RVH, URVH, and BRVH than NRVH (p<0.001), but there were no differences between URVH and BRVH. Blood pressure in 13 patients with changes in capto- pril scintigraphy improved after angioplasty, bypass surgery, or nephrectomy and PAR decreased from 13.2±7.4% to 0.7±1.8% (p=0.0312) and Dtmax decreased from 353.3±274.lsec to 40.0±49.0sec. From the above findings captopril scintigraphy were thought to be useful in the diagnosis and treatment.