Qiao Lin, Peng Jing, Hao Xiaodong, Wang Chenghui, Xie Mingliang, Ding Hao
Department of Endocrinology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China.
Department of Urology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China.
Exp Ther Med. 2024 Jul 16;28(3):367. doi: 10.3892/etm.2024.12656. eCollection 2024 Sep.
The diagnosis of primary aldosteronism (PA) is critical for determining treatment strategies. The aim of the present study was to investigate the clinical value of preoperative adrenal venous sampling (AVS) for determining the benefit of PA surgery. Patients diagnosed with PA at Liaocheng People's Hospital (Liaocheng, China) between January 2015 and December 2020 were selected and divided into two groups: Group A underwent adrenal computed tomography (CT) only, whereas Group B underwent adrenal CT and successful AVS. Subsequently, the improvement rate of adrenal CT and adrenal CT + AVS in the treatment of PA was compared. A total of 164 patients were included, with an average age of 46.69±13.64 years. There were 62 patients in Group A and 102 in Group B. Among the patients diagnosed with unilateral lesions on adrenal CT scan, 82.61% of patients in group A and 87.72% in group B showed improvement; however, the difference was not significant (χ=0.534, P=0.465). Among the patients diagnosed with bilateral lesions on adrenal CT images, 62.50% of patients in Group A and 91.11% of patients in Group B showed improvement (P=0.019). In conclusion, unilateral adrenal lesions detected by CT did not benefit significantly from surgical decision-making after AVS. AVS should be advised for all patients with bilateral adrenal PA who are willing to undergo adrenal surgery, which is conducive to correct lateral segmentation and improve treatment choices.
原发性醛固酮增多症(PA)的诊断对于确定治疗策略至关重要。本研究的目的是探讨术前肾上腺静脉采血(AVS)对于确定PA手术获益的临床价值。选取2015年1月至2020年12月在聊城市人民医院(中国聊城)被诊断为PA的患者,并将其分为两组:A组仅接受肾上腺计算机断层扫描(CT),而B组接受肾上腺CT及成功的AVS。随后,比较肾上腺CT和肾上腺CT+AVS在PA治疗中的改善率。共纳入164例患者,平均年龄为46.69±13.64岁。A组有62例患者,B组有102例患者。在肾上腺CT扫描诊断为单侧病变的患者中,A组82.61%的患者和B组87.72%的患者病情有改善;然而,差异无统计学意义(χ=0.534,P=0.465)。在肾上腺CT图像诊断为双侧病变的患者中,A组62.50%的患者和B组91.11%的患者病情有改善(P=0.019)。总之,CT检测到的单侧肾上腺病变在AVS后手术决策中未显著获益。对于所有愿意接受肾上腺手术的双侧肾上腺PA患者,均应建议进行AVS,这有助于正确的侧别划分并改善治疗选择。