静脉盐水负荷试验在原发性醛固酮增多症诊断中的价值

Evaluation of intravenous saline load test in diagnosis of primary aldosteronism

目的探讨静脉盐水负荷试验在原发性醛固酮增多症诊断中的应用价值。方法选择2006-2010年临床诊断为原发性醛固酮增多症的患者47例,行静脉盐水负荷试验并同时检测其血、尿醛固酮及血钾等生化指标。以30例原发性高血压患者作为对照组。结果与对照组比较,原发性醛固酮增多症患者静脉盐水负荷试验前、后血醛固酮水平、24h尿醛固酮排量显著升高,血钾水平明显下降;原发性醛固酮增多症患者血醛固酮的抑制率[(13.3±5.6)%]和受抑制患者的比例(4.3%)明显低于对照组[分别为(78.0±12.5)%和(93.3%)],该试验对原发性醛固酮增多症诊断的敏感性和特异性分别为95.7%(45/47)和93.3%(28/30)。结论静脉盐水负荷试验是一项安全可靠的原发性醛固酮增多症确诊方法,其敏感性和特异性均较高。

Objective To investigate the value of intravenous （i. v. ） saline load test in the diagnosis of primary aldosteronism. Methods From year 2006 to 2010, 47 patients clinically diagnosed with primary aldosteronism were performed i. v. saline load test, plasma and urinary aldosterone, and serum potassium were examined at the same time. 30 patients with essential hypertension were served as controls. Results Compared with the control group, patients with primary aldosteronism had higher plasma and urinary aldosterone, lower serum potassium. The inhibition ratio （ 13.3± 5.6）% and the proportion of patients restrained （4.3 % ） after i. v. saline load test in primary aldosteronism group were lower than those in control group [ （78.0±12.5） % and （93.3%）, respectively]. The sensitivity and specificity of i.v. saline load test for primary aldosteronism were 95.7% （45/47） and 93.3% （28/30）. Conclusions The i.v. saline load test is a safe and reliable confirmatory test for the diagnosis of primary aldosteronism with a high sensitivity and specificity.