原发性醛固酮增多症各项诊断筛查方法的临床价值

发布时间：2018-01-15 07:17

本文关键词：原发性醛固酮增多症各项诊断筛查方法的临床价值　出处：《中国老年学杂志》2016年12期 　论文类型：期刊论文

【摘要】：目的评价经手术病理证实的原发性醛固酮增多症(PA)患者术前各项诊断筛查方法与术后病理诊断的符合率。方法回顾性分析36例PA患者不同指标筛查PA的阳性率,各项确诊试验对PA确诊率及CT与术后病理的诊断符合率。结果在上述患者中,以血浆醛固酮与肾素比值(ARR)30 ng/dl为筛选条件筛查PA的阳性率为42%,以ARR50 ng/dl筛查PA的阳性率为64%(P0.01);盐水滴注抑制试验和卡托普利抑制试验对PA的确诊率分别为90.91%和92%(P0.05);与术后病理对照,CT对醛固酮腺瘤(APA)和单侧肾上腺皮质增生(UAH)的诊断符合率分别为95.24%和73.33%(P0.05)。结论 ARR50 ng/dl筛查PA的阳性率高于ARR30 ng/dl;盐水滴注抑制试验与卡托普利抑制试验确诊率相当;对于分型,CT对APA的诊断符合率与UAH相当。
[Abstract]:Objective to evaluate the pathologically proved primary aldosteronism (PAA). Methods 36 patients with PA by different indexes were analyzed retrospectively. The diagnostic rate of PA and the coincidence rate of CT and postoperative pathology were determined by each diagnostic test. The positive rate of PA was 42% based on the ratio of plasma aldosterone to renin 30 ng/dl. The positive rate of PA screening by ARR50 ng/dl was 64% (P 0.01). The diagnostic rates of PA in saline drip inhibition test and captopril inhibition test were 90.91% and 92%, respectively. Compared with postoperative pathology. The coincidence rate of CT in diagnosis of aldosterone adenoma (APA) and unilateral adrenocortical hyperplasia (UAH) was 95.24% and 73.33, respectively (P0.05). Conclusion the positive rate of PA screening by ARR50 ng/dl is higher than that by ARR30 ng / dl. The diagnostic rate of saline drip inhibition test was similar to that of captopril inhibition test. The diagnostic coincidence rate of CT in APA was similar to that of UAH.
【作者单位】：河北医科大学唐山工人医院内分泌科;
【基金】：河北省科技计划项目(15277788D)
【分类号】：R586.24
【正文快照】： 原发性醛固酮增多症(PA)是继发性高血压的常见原因之一,其主要类型为醛固酮腺瘤(APA)和单侧肾上腺皮质增生(UAH)。以往观点认为PA仅占高血压患者的0.4%~2%,近年来采用血浆醛固酮/血浆肾素活性比值(ARR)对血钾正常的高血压患者筛查,发现近10%以上为PA。本文拟回顾性分析不同指

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