Pirich K, Vierhapper H, Graninger W, Nowotny P, Waldhäusl W
Abteilung für Klinische Endokrinologie und Diabetologie, I. Medizinische Universitätsklinik, Wien.
Wien Klin Wochenschr. 1987 Sep 11;99(17):608-11.
In order to evaluate whether changes in the plasma concentration of aldosterone (PA) following the administration of captopril, an inhibitor of angiotensin-converting enzyme, will establish the diagnosis of primary aldosteronism we have used this test in 9 healthy subjects and in 22 patients with various forms of hypertension, including 5 patients with primary aldosteronism due to idiopathic adrenal hyperplasia (n = 4) or aldosterone-producing adenoma (n = 1). The response of PA to captopril (25 mg orally) was investigated on an outpatient basis, following a rest period of 120 minutes in the supine position. In healthy subjects PA decreased from a mean basal value of 11.5 +/- 5.9 ng/dl to less than 6.4 ng/dl (4.9 +/- 1.4 ng/dl [p less than 0.01]). Similarly, captopril induced a fall in PA concentration to less than 6.4 ng/dl in patients with essential hypertension, with renal artery stenosis or with an afunctional kidney. Post-captopril concentrations of plasma aldosterone were about twice the normal level in 3 of 4 patients with idiopathic adrenal hyperplasia and about four-fold raised above normal in the patient with an aldosterone-producing adenoma. In spite of a false-negative result in one patient with idiopathic adrenal hyperplasia, the administration of captopril appears to be of use in recognizing patients with primary aldosteronism on an outpatient basis.
为了评估给予血管紧张素转换酶抑制剂卡托普利后血浆醛固酮（PA）浓度的变化是否能确诊原发性醛固酮增多症，我们对9名健康受试者和22名患有各种类型高血压的患者进行了此项检测，其中包括5名因特发性肾上腺增生（n = 4）或醛固酮瘤（n = 1）导致的原发性醛固酮增多症患者。在门诊情况下，让受试者仰卧休息120分钟后，口服25毫克卡托普利，研究PA的反应。在健康受试者中，PA从平均基础值11.5±5.9纳克/分升降至低于6.4纳克/分升（4.9±1.4纳克/分升[p < 0.01]）。同样，卡托普利使原发性高血压、肾动脉狭窄或无功能肾患者的PA浓度降至低于6.4纳克/分升。4名特发性肾上腺增生患者中有3名卡托普利给药后血浆醛固酮浓度约为正常水平的两倍，醛固酮瘤患者的该浓度则比正常水平高出约四倍。尽管1名特发性肾上腺增生患者出现假阴性结果，但卡托普利给药似乎有助于在门诊识别原发性醛固酮增多症患者。
