Suppr超能文献

肾上腺静脉采血在原发性醛固酮增多症外科治疗中的应用价值

Application value of adrenal venous sampling in the surgical treatment of primary aldosteronism.

作者信息

Qiao Lin, Peng Jing, Hao Xiaodong, Wang Chenghui, Xie Mingliang, Ding Hao

机构信息

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.

出版信息

Exp Ther Med. 2024 Jul 16;28(3):367. doi: 10.3892/etm.2024.12656. eCollection 2024 Sep.

Abstract

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.

摘要

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。

相似文献

1
Application value of adrenal venous sampling in the surgical treatment of primary aldosteronism.
Exp Ther Med. 2024 Jul 16;28(3):367. doi: 10.3892/etm.2024.12656. eCollection 2024 Sep.
2
Primary aldosteronism subtype discordance between computed tomography and adrenal venous sampling.
Hypertens Res. 2019 Dec;42(12):1942-1950. doi: 10.1038/s41440-019-0310-y. Epub 2019 Aug 13.
3
Value of adrenal venous sampling for lesion localization in primary aldosteronism.
World J Surg. 2012 Oct;36(10):2522-7. doi: 10.1007/s00268-012-1695-9.
5
The value of CT-based energy imaging to discriminate dominant side lesions in primary aldosteronism.
Front Endocrinol (Lausanne). 2023 Apr 14;14:1121388. doi: 10.3389/fendo.2023.1121388. eCollection 2023.
9
Surgery based on computed tomography images might be feasible for primary aldosteronism patients with visible unilateral adenoma.
J Clin Hypertens (Greenwich). 2023 Nov;25(11):1001-1008. doi: 10.1111/jch.14725. Epub 2023 Oct 4.
10
Sex modifies the predictive value of computed tomography combined with serum potassium for primary aldosteronism subtype diagnosis.
Front Endocrinol (Lausanne). 2023 Nov 16;14:1266961. doi: 10.3389/fendo.2023.1266961. eCollection 2023.

本文引用的文献

1
Diagnosis and treatment of primary aldosteronism.
Lancet Diabetes Endocrinol. 2021 Dec;9(12):876-892. doi: 10.1016/S2213-8587(21)00210-2.
2
Primary aldosteronism in elderly, old, and very old patients.
J Hum Hypertens. 2020 Dec;34(12):807-813. doi: 10.1038/s41371-020-00395-2. Epub 2020 Sep 14.
3
Low-grade Cortisol Cosecretion Has Limited Impact on ACTH-stimulated AVS Parameters in Primary Aldosteronism.
J Clin Endocrinol Metab. 2020 Oct 1;105(10). doi: 10.1210/clinem/dgaa519.
4
Disease monitoring of Primary Aldosteronism.
Best Pract Res Clin Endocrinol Metab. 2020 Mar;34(2):101417. doi: 10.1016/j.beem.2020.101417. Epub 2020 Mar 10.
5
Controversies and advances in adrenal venous sampling in the diagnostic workup of primary aldosteronism.
Best Pract Res Clin Endocrinol Metab. 2020 May;34(3):101400. doi: 10.1016/j.beem.2020.101400. Epub 2020 Feb 22.
6
Computed Tomography and Adrenal Venous Sampling in the Diagnosis of Unilateral Primary Aldosteronism.
Hypertension. 2018 Sep;72(3):641-649. doi: 10.1161/HYPERTENSIONAHA.118.11382.
8
The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline.
J Clin Endocrinol Metab. 2016 May;101(5):1889-916. doi: 10.1210/jc.2015-4061. Epub 2016 Mar 2.
9
Outcome of surgical treatment of primary aldosteronism.
Langenbecks Arch Surg. 2015 Apr;400(3):325-31. doi: 10.1007/s00423-014-1269-4. Epub 2015 Jan 8.
10
An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism.
Hypertension. 2014 Jan;63(1):151-60. doi: 10.1161/HYPERTENSIONAHA.113.02097. Epub 2013 Nov 11.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验