盐水负荷试验对原发性醛固酮增多症的诊断价值

Diagnostic Value of Saline Infusion Test in Patients With Primary Aldosteronism

目的:评价盐水负荷试验对于原发性醛固酮增多症(PHA)的诊断价值。方法:回顾性分析1994-06至2012-05我院72例PHA患者(PHA组)和44例排除PHA的原发性高血压(EH)患者(EH组)的临床资料。并应用受试者工作曲线(ROC曲线)对盐水负荷试验前后血浆醛固酮水平及试验后血浆醛固酮/肾素活性比值进行评价,分析其诊断效能,得出最佳诊断切点。结果:试验后血浆醛固酮水平ROC曲线下面积为0.759,敏感性为74.6%,特异性为63.6%。试验后血浆醛固酮/肾素活性比值ROC曲线下面积为0.899,敏感性为83.6%,特异性为88.6%,最佳诊断切点为111[ng/dl:ng/(ml·h)]。结论:盐水负荷试验后血浆醛固酮水平及血浆醛固酮/肾素活性比值,对于PHA均有诊断价值,试验后血浆醛固酮/肾素活性比值诊断效能更高。

Objective： To evaluate the diagnostic value of saline infusion test （SIT） in patients with primary aldosteronism （PHA）. Methods： A total of 116 patients with PHA or essential hypertension （EH） treated in our hospital from 1994-06 to 2013- 05 were retrospectively studied. The patients were divided into 2 groups： PHA group, n=72 and EH group, the patients with excluded PHA, n=44. post-SIT plasma levels of aldosterone and post-SIT ratio of aldosterone/renin activity were evaluated by ROC curve in order to analyze the diagnostic capability and the best diagnostic cut-offpoint. Results： The area under curve （AUC） by ROC for post-SIT aldosterone level was 0.759, the sensitivity and specificity were 74.6% and 63.6% respectively; AUC for post-SIT ratio of aldosterone/renin activity was 0.899, the sensitivity and specificity were 83.6% and 88.6% with the best diagnostic cut-offpoint at 111 [ng/dl：ng/（ml.h）]. Conclusion： Post-SIT plasma level of aldosterone and post-SIT ratio of aldosterone/renin activity had the diagnostic value of PHA; post-SIT ratio of aldosterone/renin activity had the higher diagnostic value of PHA.