Vierhapper H
Division of Endocrinology and Metabolism, Department of Internal Medicine III, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Exp Clin Endocrinol Diabetes. 2007 Sep;115(8):518-21. doi: 10.1055/s-2007-973058.
To determine the prevalence of primary aldosteronism among patients with incidentally discovered adrenal adenomas ('incidentalomas') plasma concentrations of aldosterone (PA) and plasma renin activity (PRA) were determined in 269 patients (100 normotensives, 169 hypertensives) newly referred incidentaloma patients. Among the 100 normotensives a PA [ng/dl]/PRA [ng/ml.h]-ratio (A/R-R) >50 and a concomitant elevation of PA (>15 pg/ml) was initially seen in two cases but further investigations excluded the presence of primary aldosteronism in both patients suggesting a prevalence of primary aldosteronism of <1% among normotensive patients with adrenal incidentaloma. Among the 169 hypertensive incidentaloma patients 14 presented with both, an elevated PA [>15 pg/ml] and an A/R-R >50. Primary aldosteronism was confirmed in 6 of this cases resulting in a prevalence of primary aldosteronism among hypertensive incidentaloma patients of 4%. Although obtained in patients with a supposedly high pre-test probability of primary aldosteronism this percentage--while in keeping with the older literature--is surprisingly low given the recently reported large(r) prevalence of primary aldosteronism among hypertensives in general.
为了确定偶发性肾上腺腺瘤（“偶发瘤”）患者中原发性醛固酮增多症的患病率，我们对269例新转诊的偶发瘤患者（100例血压正常者，169例高血压患者）测定了血浆醛固酮（PA）浓度和血浆肾素活性（PRA）。在100例血压正常者中，最初有2例PA [ng/dl]/PRA [ng/ml·h]比值（A/R-R）>50且PA同时升高（>15 pg/ml），但进一步检查排除了这两名患者中原发性醛固酮增多症的存在，提示在肾上腺偶发瘤的血压正常患者中原发性醛固酮增多症的患病率<1%。在169例高血压偶发瘤患者中，有14例同时出现PA升高（>15 pg/ml）和A/R-R>50。其中6例确诊为原发性醛固酮增多症，导致高血压偶发瘤患者中原发性醛固酮增多症的患病率为4%。尽管该百分比是在原发性醛固酮增多症预测试概率较高的患者中获得的，但与旧文献一致的是，鉴于最近报道的一般高血压患者中原发性醛固酮增多症的患病率较高，这一百分比出奇地低。
