【摘要】 目的:评估血浆醛固酮(ALD)、醛固酮/肾素活性比值(ARR)、ALD联合ARR在高血压患者中对原发性醛固酮增多症(PA)的诊断价值。方法:收集于我院和医联体医院就诊的346例ARR>15的高血压患者。根据卡托普利试验(CCT)/静脉盐水负荷试验(SIT)结果,患者被分为原发性高血压(EH)组(237例)和PA组(109例)。比较两组一般资料,分析比较ALD、ARR及ALD联合ARR对PA的诊断价值。结果:346例患者中有109例(31.5%)确诊为PA。与EH组比较,PA组血清钾浓度[(3.84±0.40)mmol/L比(3.64±0.38)mmol/L]显著降低,血浆ALD[140.11(104.79, 186.39)pg/ml比228.60(173.96, 294.93)pg/ml]、ARR[(25.05±10.55)比(43.36±16.86)]显著升高,P均=0.001。与ALD比较,ARR、ALD联合ARR的曲线下面积(0.791比0.881、0.889)均显著升高,P均<0.01;ARR的敏感度(87.2%比95.4%),ARR、ALD联合ARR的特异度(62.0%比73.0%、79.3%)均显著升高,P<0.05或<0.01。结论:ARR,ALD联合ARR诊断价值原发性醛固酮增多症的价值显著优于ALD,而ARR与ALD联合ARR的诊断价值相当。更多还原

【Abstract】 Objective:To assess diagnostic value of plasma aldosterone(ALD), aldosterone/renin activity ratio(ARR) and ALD+ARR for primary aldosteronism(PA) in hypertensive patients.Methods:A total of 346 ARR>15 hypertensive patients treated in our hospital and medical consortium hospitals were collected. According to outcomes of captopril challenge test(CCT)/saline infusion test(SIT), patients were divided into essential hypertension(EH) group(n=237) and PA group(n=109). General data were compared between two groups, and diagnostic value of ALD, ARR and ALD+ARR for PA were compared and analyzed.Results:A total of 109 cases(31.5%) were diagnosed as PA in the 346 patients. Compared with EH group, there was significant reduction in serum potassium concentration [(3.84±0.40)mmol/L vs.(3.64±0.38)mmol/L], and significant rise in plasma ALD level [140.11(104.79, 186.39)pg/ml vs. 228.60(173.96, 294.93)pg/ml]and ARR [(25.05±10.55) vs.(43.36±16.86)]in PA group, P=0.001 all. Compared with ALD, there was significant rise in AUC(0.791 vs. 0.881, 0.889) of ARR and ALD+ARR, P<0.01 both; there was significant rise in sensitivity(87.2% vs. 95.4%) in ARR, and specificity(62.0% vs. 73.0%, 79.3%) in ARR and ALD+ARR, P<0.05 or <0.01.Conclusion: The diagnostic value of ARR and ALD combined ARR are significantly superior to ALD,but the diagnostic value of ARR is similar to ALD combined with ARR.更多还原