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醛固酮/血浆肾素活性比值是筛查原发性醛固酮增多症患者的一个敏感参数。

[Aldosterone/plasma renin activity ratio is a sensitive parameter for screening patients with primary aldosteronism].

作者信息

Zhang Hui-lan, Liu Zhen-jiang, Shao Jiao-mei, Yan Jiang-tao, Wang Dao-wen

机构信息

Cardiovascular Department of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2006 Oct;34(10):873-6.

Abstract

OBJECTIVE

To screen primary aldosteronism cases with ARR (aldosterone/plasma renin activity, ARR) from patients with hypertension, and to evaluate the diagnosis value of ARR in primary aldosteronism cases and analysis the clinical characters of primary aldosteronism cases.

METHODS

Nine hundred and two patients with hypertension were collected, the plasma aldosterone concentration to plasma renin activity ratio were detected by radio-immunity method, after that, ARR were calculated. Retrospective analysis was made of clinical data in 126 primary aldosteronism cases, which ARR were over 25.

RESULTS

One hundred and twenty-six cases (14%) were diagnosed as primary aldosteronism, and of them, 49 cases had hypokalemia. 25 patients received surgical operation and the rate of efficiency and cure of surgery treatment were 100% and 48%, respectively. The rate of efficiency and cure of drug treatment was 89% and 24% respectively.

CONCLUSIONS

Primary aldosteronism affects over 10% of patients with hypertension in China. Patients with hypertension and most patients with treatment-resistant hypertension should undergo screening for primary aldosteronism with ARR. A high ARR is a positive screening test result, a finding that warrants confirmatory testing.

摘要

目的

从高血压患者中筛查出醛固酮/血浆肾素活性比值(ARR)升高的原发性醛固酮增多症患者,评估ARR在原发性醛固酮增多症中的诊断价值,并分析原发性醛固酮增多症患者的临床特征。

方法

收集902例高血压患者,采用放射免疫法检测血浆醛固酮浓度与血浆肾素活性比值,计算ARR。对126例ARR大于25的原发性醛固酮增多症患者的临床资料进行回顾性分析。

结果

126例(14%)患者被诊断为原发性醛固酮增多症,其中49例有低钾血症。25例患者接受手术治疗,手术治疗的有效率和治愈率分别为100%和48%。药物治疗的有效率和治愈率分别为89%和24%。

结论

在中国,原发性醛固酮增多症影响超过10%的高血压患者。高血压患者以及大多数难治性高血压患者应采用ARR筛查原发性醛固酮增多症。ARR升高是筛查试验阳性结果,这一结果需要进行确诊试验。

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