两种体位激发试验对醛固酮瘤的诊断价值

Comparison of the clinical values of two different posture tests for diagnosis of aldosterone producing adenoma

目的:比较单纯体位激发试验及体位联合呋塞米双重激发试验对临床确诊的醛固酮瘤(APA)患者肾素活性(PRA)、醛固酮(ALD)、醛固酮/肾素比值(ARR)的影响。方法:对112例经我院手术切除并行病理检查确诊为醛固酮瘤(APA)的患者进行统计分析,其中60例术前行单纯体位激发试验(单纯激发组),52例行体位联合呋塞米双重激发试验(双重激发组),比较两组患者的一般情况、PRA、ALD数值,并计算ARR。结果:行体位联合呋塞米双重激发试验与单纯体位激发试验患者的一般情况、PRA、ALD、ARR均无显著性差异,双重激发组不良反应更多见,与单纯体位激发组相比差异有统计学意义(P<0.05)。结论:在体位激发试验中是否加用呋塞米对APA患者的ARR影响不大,反而增加了不良反应的发生率。

Objective：To study the changes of plasma rennin activity（PRA）,aldosterone（ALD） and aldosterone/rennin ratio（ARR） in response to posture test（single stimulation） and posture-furosemide test（double stimulation） in patients confirmed with aldsterone-producing adenoma（APA）.Methods：Retrospective chart review was conducted on 112 APA patients who were confirmed by surgery and postoperative biopsy.Posture tests were performed on 60 patients,and posture-furosemide tests were conducted on 52 patients before surgery.Clinical characteristics,PRA,ALD,and ARR were compared.Results：No significant differences were observed between the two groups in clinical characteristics,PRA,ALD or ARR,whereas the frequency of side-effect related to the tests was higher in the double-stimulation group.Conclusion：The difference was not obvious whether or not furosemide was added in the posture test to evaluate APA,it might increase side-effects instead.