高血压鉴别诊断性实验的研究分析

Nursing for diagnosis of experimental identification of hypertension

目的 探讨生理盐水滴注抑制试验、卡托普利抑制试验诊断原发性醛固酮增多症的临床意义及护理措施。方法 收集2012年1～7月在我科治疗的56例高血压患者的临床资料,行生理盐水滴注抑制试验和卡托普利抑制试验诊断高血压原因,比较确诊病例与疑似病例的血浆醛固酮、肾素、醛固酮/肾素活性比值。结果 10例原发性高血压,46例继发性高血压,其中确诊原发性醛固酮增多症18例,疑似病例28例,两组的性别、年龄、收缩压及舒张压比较差异无显著意义（P〉0.05）,具有可比性。两组血浆醛固酮的平均值分别为30.8ng/L、12.9ng/L,肾素0.26ng/（ml·h）、0.54ng/（ml·h）,醛固酮/肾素活性比值150.1、23.2,差异有显著意义（P〈0.001）。结论 生理盐水滴注抑制试验和卡托普利抑制试验是筛选、确诊原发性醛固酮增多症的主要手段,护理是准确地进行试验的关键,试验前仔细准备,试验中严格用药、病情观察、准确采集标本,试验后观察及记录检查结果非常重要。

Objective To study the clinical significance and nursing measurement for primary aldosteronism （PA） diagnosis by Inhibition test of saline infusion and Lidocaine Infusion .Method Clinical data of 56 patients with hyper‐tension from January 2012 to July 2012 in our department was collected .Inhibition test of saline infusion and Lido‐caine Infusion was conducted for hypertension diagnosis .The plasma aldosterone ,aldosterone renin and Plasma aldo‐sterone renin activity ratio was measured and compared between confirmed and suspected cases of the disease .Result There were 10 patients with primary hypertension ,46 patients with secondary hypertension .Among which ,18 pa‐tients was confirmed as primary aldosteronism ,28 patients was diagnosed as suspected patients .There was no signif‐icant difference in sex ,age ,systolic and diastolic blood pressure between the two groups（P〉0 .05） .The average con‐tent was 30 .8 ng/L and 12 .9 ng/L for plasma aldosterone ,0 .26 ng/L and 0 .54 ng/L for rennin ,150 .1 and 23 .2 for plasma aldosterone renin activity ratio respectively for the two group .There was significant difference bttween two groups（P〈0 .001） .Conclusion The inhibition test of saline infusion and Lidocaine infusion was the important meth‐od for screening and confirming primary aldosteronism .Nursing ,careful preparation before test ,Strict medication during test ,patients’ condition observation ,accurate specimen collection ,investigation and results of the experiment concept record was was the key for accurate test .