Vecsei P, Benraad T J, Hofman J, Abdelhamid S, Haack D, Lichtwald K
Clin Chem. 1982 Mar;28(3):453-6.
For distinguishing primary aldosteronism from essential hypertension, we use simple direct radioimmunoassays for "aldosterone" (aldosterone and other materials that react with the antibody to aldosterone) and "18-hydroxycorticosterone" (similarly) in unprocessed urine. Patients with primary aldosteronism have high values for "aldosterone." This diagnosis can be validated by assays of further urine samples from the same person and by additional direct assays for "18-hydroxycorticosterone." In none of 65 urine samples from 26 patients with primary aldosteronism were both "aldosterone" and "18-hydroxycorticosterone" values within their reference intervals. However, a few "aldosterone" and "18-hydroxycorticosterone" values for patients with essential hypertension and normal aldosterone excretion were also (moderately) increased. Thus, when high values are found, true aldosterone values must be estimated by extraction and chromatography, to eliminate false positives. The "aldosterone" and "18-hydroxycorticosterone" values by our procedure are much higher than the corresponding values for urinary free aldosterone and 18-hydroxycorticosterone. Although not identified, the immunoactive materials are probably metabolites of aldosterone and 18-hydroxycorticosterone.
为了鉴别原发性醛固酮增多症与原发性高血压，我们采用简单的直接放射免疫分析法，检测未经处理尿液中的“醛固酮”（醛固酮及其他能与醛固酮抗体发生反应的物质）和“18 - 羟皮质酮”（同理）。原发性醛固酮增多症患者的“醛固酮”值较高。该诊断可通过检测同一患者的更多尿液样本以及对“18 - 羟皮质酮”进行额外的直接检测来验证。在26例原发性醛固酮增多症患者的65份尿液样本中，“醛固酮”和“18 - 羟皮质酮”的值均不在其参考区间内。然而，一些原发性高血压且醛固酮排泄正常患者的“醛固酮”和“18 - 羟皮质酮”值也（中度）升高。因此，当发现值升高时，必须通过萃取和色谱法来估算真正的醛固酮值，以消除假阳性。按照我们的方法检测得到的“醛固酮”和“18 - 羟皮质酮”值远高于尿游离醛固酮和18 - 羟皮质酮的相应值。虽然尚未明确，但这些免疫活性物质可能是醛固酮和18 - 羟皮质酮的代谢产物。
