Stokes G S, Monaghan J C, Mennie B A
Aust N Z J Med. 1984 Jun;14(3):201-7. doi: 10.1111/j.1445-5994.1984.tb03751.x.
A sodium loading test was performed in 35 patients presenting with hypertension and hypokalemia. In 14 of these patients, intravenous administration of 0.9% saline (2 l in 4 h) on two consecutive days caused urinary aldosterone excretion to fall to values within the range for normal volunteers. The other 21 patients, in whom urinary aldosterone excretion did not decline following two days of saline loading, or in whom pronounced hypokalemia after the first day of loading precluded further saline infusion, were designated as having primary aldosteronism. Seventeen of this group underwent surgery and discrete adrenal adenomas were found in 16. When serum potassium concentration, plasma renin activity or the relationships of serum potassium to concurrent urinary potassium excretion or of urinary aldosterone excretion to plasma renin activity were used as alternative diagnostic criteria for primary aldosteronism, overlapping of the two groups occurred. It is concluded that measurement of urinary aldosterone excretion after intravenous sodium loading is a useful test in the test in the identification of primary aldosteronism due to aldosterone-producing adenoma. In this series the saline loading test was more specific in diagnosis than criteria based on serum and urinary potassium, plasma renin activity or unsuppressed aldosterone excretion.
对35例高血压伴低钾血症患者进行了钠负荷试验。其中14例患者连续两天静脉输注0.9%生理盐水（4小时内输注2升）后，尿醛固酮排泄量降至正常志愿者范围内。另外21例患者，在进行两天生理盐水负荷试验后尿醛固酮排泄量未下降，或在负荷试验第一天后出现明显低钾血症而无法进一步输注生理盐水，被诊断为原发性醛固酮增多症。该组中有17例接受了手术，其中16例发现了孤立性肾上腺腺瘤。当血清钾浓度、血浆肾素活性或血清钾与同时期尿钾排泄的关系、尿醛固酮排泄与血浆肾素活性的关系用作原发性醛固酮增多症的替代诊断标准时，两组之间出现了重叠。结论是，静脉钠负荷后测定尿醛固酮排泄量是一项有助于识别由醛固酮分泌腺瘤引起的原发性醛固酮增多症的试验。在本系列研究中，生理盐水负荷试验在诊断方面比基于血清和尿钾、血浆肾素活性或未受抑制的醛固酮排泄的标准更具特异性。
