Coruzzi P, Musiari L, Biggi A, Carra N, Panzali A F, Novarini A
Istituto di Semeiotica Medica, Università di Parma, Italy.
Am J Hypertens. 1991 Aug;4(8):694-9. doi: 10.1093/ajh/4.8.694.
Isotonic-isooncotic central volume expansion by head-out water immersion was induced in six aldosterone-producing adenoma subjects and in six patients with idiopathic hyperaldosteronism. Plasma renin activity and plasma aldosterone levels did not significantly change during water immersion while serum cortisol was significantly suppressed (P less than .001) and the aldosterone-cortisol ratio increased (P less than .02) in aldosterone-producing adenoma patients. Water immersion also revealed the failure of plasma aldosterone levels to decrease below 10 ng/dL in these subjects, thus confirming previous results obtained during isotonic saline infusion. Otherwise, plasma renin activity and plasma aldosterone were significantly reduced (P less than .05 and P less than .01 respectively) by water immersion and plasma aldosterone invariably fell below 10 ng/dL in patients with idiopathic aldosteronism. In view of the diagnostic reliability of such a suppression test we conclude that water immersion is suitable for discriminating between the two forms of primary aldosteronism. We therefore suggest its use for assessing renin-aldosterone responsiveness in primary aldosteronism.
对6例原发性醛固酮增多症患者和6例特发性醛固酮增多症患者进行头低位水浸浴，以诱导等渗等容性中心血容量扩张。在水浸浴期间，原发性醛固酮增多症患者的血浆肾素活性和血浆醛固酮水平无显著变化，而血清皮质醇显著降低（P<0.001），醛固酮-皮质醇比值升高（P<0.02）。水浸浴还显示，这些患者的血浆醛固酮水平未能降至10 ng/dL以下，从而证实了先前在输注等渗盐水期间获得的结果。否则，特发性醛固酮增多症患者的血浆肾素活性和血浆醛固酮水平因水浸浴而显著降低（分别为P<0.05和P<0.01），且血浆醛固酮总是降至10 ng/dL以下。鉴于这种抑制试验的诊断可靠性，我们得出结论，水浸浴适用于区分两种原发性醛固酮增多症。因此，我们建议使用水浸浴来评估原发性醛固酮增多症患者的肾素-醛固酮反应性。
