原发性醛固酮增多症的分型、定侧诊断

Diagnosis of subtypes and lateralization for primary hyperaldosteronism

目的 :探讨CT及体位刺激试验对原发性醛固酮增多症 (原醛 )分型、定侧诊断的价值。方法 :采用回顾性研究方法 ,对 2 2例原醛患者的临床资料及病理结果进行统计分析。结果 :醛固酮腺瘤 (APA)患者基础血浆醛固酮水平 (PAC)多 >2 5 0pg·ml-1。CT检查诊断APA的灵敏度为 75 % ,特异度 10 0 % ;体位刺激试验分别为 87%和 10 0 %。两方法诊断结果无显著相关性 (P >0 .0 5 ) ,两者结果一致性较差 (P >0 .0 5 ) ,但两者诊断效能差异无显著性 (P >0 .0 5 )。结论 :临床诊断APA以基础PAC及体位刺激试验为最佳。CT和体位刺激试验对APA均具较好的诊断价值 。

Objective To evaluate the value of CT and posture stimulation test (PST) in the differential diagnosis and lateralization of primary hyperaldosteronism(PA). Method Retrospective study was done based on the clinical data and pathological examinations of 22 patients with PA. Results The baseline plasma aldosterone concentration (PAC) of most aldosterone-producing adenomas (APAs) was over 250 pg·ml -1 . In the diagnosis of APA, the senstivity of CT was 75% and the specificity of CT was 100%; the senstivity and specificity of PST were 87% and 100%, respectively. The examination results of CT and PST had no statistical significant correlativity (P>0.05) and had bad consistency (P>0.05), and the diagnostic efficiency of them had no significant difference (P>0.05). Conclusions The baseline PAC and the result of PST suggest as the best diagnostic index and methods of APA. Both CT and PST have high value in the differential diagnosis. Both CT and PST cannot be substituted for each other.