captopril test

The captopril test was carried out according to the following principle. Under normal physiological conditions, the renin-angiotensin system is the main factor regulating aldosterone secretion, and the biologically active angiotensin can stimulate the secretion of aldosterone. Captopril is an angiotensin-converting enzyme inhibitor that blocks the conversion of angiotensin I to active angiotensin II, thereby attenuating the secretion of aldosterone and lowering aldosterone levels in the blood. In patients with primary aldosteronism, aldosterone secretion is not dependent, or only partially dependent on the regulation of the renin-angiotensin system, and the secretion of aldosterone after captopril is not inhibited. Excessive renin secreted by patients with renal artery stenosis can be blocked by captopril and converted to angiotensin II, resulting in reduced aldosterone secretion. Basic Information Specialist classification: urinary examination classification: blood examination Applicable gender: whether men and women apply fasting: fasting Analysis results: Below normal: Normal value: no Above normal: negative: normal. Positive: Plasma aldosterone was inhibited to 416 pmol/L (15 μg/L) after administration in normal subjects and essential hypertension, which was significantly lower than before administration. The plasma aldosterone level after primary aldosteronism did not decrease or slightly decreased before taking the drug, that is, the test was positive. Tips: Because of the position and environment, it has an effect on the secretion of renin and aldosterone. Therefore, 2 hours before the test to the end of the test, the same position should be maintained, and the environment should be quiet to avoid strong sound and light stimulation. Normal value Plasma aldosterone was inhibited to 416 pmol/L (15 μg/L) after administration in normal subjects and essential hypertension, which was significantly lower than before administration. Clinical significance Abnormal results: 1. Plasma aldosterone was inhibited to 416 pmol/L (15 μg/L) after administration of normal hypertension and essential hypertension, which was significantly lower than before administration. The plasma aldosterone level after primary aldosteronism did not decrease or slightly decreased before taking the drug, that is, the test was positive. 2. Renal vascular hypertension test is positive. Predicting the surgical effect, the positive reaction of renal vascular hypertension surgery is better. People who need to be examined: atypical primary aldosteronism, unexplained hypertension with intermittent high blood pressure, especially those who are contraindicated in the saline infusion test. Positive results may be diseases: renal artery stenosis, primary aldosteronism considerations Contraindications before examination: severe renal impairment. Requirements for examination: due to body position, environment has an effect on the secretion of renin and aldosterone, so 2 hours before the test to the end of the test, should maintain the same position, quiet environment, avoid strong sound and light stimulation. Inspection process method one: Captopril, 25 mg, orally, blood aldosterone levels were measured before and 2 hours after taking the drug. Quietly lying from 2 hours before the test to the second blood. The results were determined: the plasma aldosterone level after taking the drug was positive compared with that before the administration. Method Two: This test was performed in a catheterization chamber. 1. Puncture the femoral vein, send the catheter, take bilateral renal venous blood, and simultaneously draw peripheral venous blood, determine the renin activity, calculate the renal venous renin ratio (RVRR), and measure blood pressure. 2. Captopril, 25mg-50mg, orally, or 25mg, slowly intravenously. Peripheral venous blood was taken again 20 minutes after intravenous injection or 30 minutes after oral administration. Bilateral renal venous blood was taken, renin activity was measured, RVRR was calculated, and blood pressure was measured. The following results are positive for the test: 1 diastolic blood pressure decreased by ≥9.3% after administration; 2 peripheral blood renin activity ≥ 14.76nmol / Lh after administration; 3 RVRR ≥ 3.3 after administration. Not suitable for the crowd Inappropriate crowd: temporarily unknown. Adverse reactions and risks No related complications or hazards.