選択された高血圧患者の検査は,急速配列の静脈内泌尿検査による
H A Cameron1, C F Close, W W Yeo
1University Department of Medicine and Pharmacology, Royal Hallamshire Hospital, Sheffield, UK.
Lancet (London, England)
|March 14, 1992
まとめ
急速シーケンスの静脈注射泌尿図 (IVU) は高血圧の重要なスクリーニングツールであり,患者の27%で異常を検出します. 制限があるにもかかわらず,腎血管疾患のような状態を効果的に特定し,必要な介入を導くことができます.
科学分野:
- ネフロロジーはネフロロジーを用います.
- 放射線学 放射線学
- 高血圧の研究 高血圧の研究
背景:
- 急速シーケンスの静脈注射泌尿図 (IVU) は,腎血管疾患を検出する際に不正確であると認識されているため,高血圧に対する使用が減少しています.
- 慎重に選択された高血圧患者のスクリーニングテストとしてIVUの有効性に関する研究は限られています.
研究 の 目的:
- 腎臓または腎血管疾患の臨床指標を有する高血圧患者の急速配列IVUの診断収率を評価する.
- 高血圧における様々な腎臓異常の一般的なスクリーニングテストとしてのIVUの有用性を評価する.
主な方法:
- 高血圧クリニックからの症例記録の遡及的レビュー.
- 241人の連続した高血圧患者で,急速配列のIVUを受ける241人の連続した高血圧患者で,診断収量と介入率の分析.
主要な成果:
- IVUは27%の患者で異常を特定し,慢性発炎 (6%),既知の腎血管疾患 (5%),および結石 (4%) を含む.
- 患者の5%で高血圧管理のための介入が促され,4%は別々の介入を必要とする異常があった.
- 不必要な侵襲的検査は,症例の3%で発生し,臨床的特徴は特定の異常を確実に予測できませんでした.
結論:
- 急速配列IVUは,腎臓または腎血管疾患の疑いのある高血圧患者の幅広い腎臓異常を検出できる唯一の単一の検査です.
- 正常なIVUは93%の確率で腎血管疾患を除外しますが,約20%の症例が欠け,不完全なスクリーニングテストです.
- 腎臓動脈造影は,腎血管疾患を決定的に排除するために,重要な場合,通常のIVUでも不可欠です.
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