肾上腺静脉取血术患者右肾上腺静脉开口的定位

Location of right adrenal vein opening in patients with adrenal vein sampling

目的探讨肾上腺静脉取血术患者右肾上腺静脉开口的分布特点。方法收集2006年1月-2013年10在新疆维吾尔自治区人民医院高血压中心住院、诊断明确的原发性醛固酮增多症（primary aldosteronism,PA）并成功进行了肾上腺静脉取血术（adrenal vein sampling,AVS）患者575例,以脊椎为标志将胸椎（Th）10中缘～腰椎（L）1中缘之间分为6组：A组：Th10中缘～Th11下缘,B组：Th11下缘～Th12上缘,C组：Th12上缘～Th12中缘,D组：Th12中缘～Th12下缘,E组：Th12下缘～L1上缘,F组：L1上缘～L1中缘,以此标记右肾上腺静脉开口并存储结果。应用SIM-ADS V4.2医学影像工作站分析在右肾上腺静脉开口的分布特征。结果 （1）右肾上腺静脉开口定位由多到少依次为C组、A组、B组、D组、E组和F组。（2）右肾上腺静脉开口定位在A、B、C、D组的患者中,男性多于女性（P〈0.05）,右肾上腺静脉开口定位在E、F组的患者中,女性多于男性（P〈0.05）;定位在A、B、C、D组的患者身高高于E组患者（P〈0.05）;定位在A组的患者体质指数高于C、D、E组患者（P〈0.05）,定位在B、C、D组患者的体质指数高于E组（P〈0.05）;定位在A组的患者腹围明显大于E、F组患者,定位在B、C、D组的患者腹围明显大于E组患者（P〈0.05）;其余组间的性别、身高、体质指数及腹围的差异无统计学意义。（3）右肾上腺静脉开口在不同年龄及民族的分布差异无统计学意义。结论综合评价性别、身高、体质指数、腹围因素,有助于右肾上腺静脉开口的定位。

Objective To investigate the distribution characteristics of the right adrenal vein opening,in order to improve the success rate of intubation of right adrenal vein.Methods 575 patients hospitalized in hypertension center of people′s Hospital of Xinjiang Uygur Autonomous Region from Jan.2006 to Oct.2013 were collected.All the patients had original aldosteronism and applied adrenal vein sampling（AVS）successfully.According to the symbol of the spine,from Th10′s middle edge to L1′s middle edge,the right adrenal vein opening of the patients were divided into 6groups,group A：the middle edge of the Th10 to Th11′s lower edge;group B：Th11′s lower edge to Th12′s upper edge;group C：Th12′s upper edge to Th12′s middle edge;group D：Th12′s middle edge to Th12′s lower edge;group E：Th12′s lower edge to L1′s upper edge;group F：L1′s upper edge to L1′s middle edge.Then,the openings of the right adrenal vein were marked and the result were stored.SIM-ADS V4.2 medical image workstation were used to analyze the distribution characteristics of right adrenal vein openings.Results（1）The right adrenal vein opening location frequency from high to low were C group,A group and B group,group D,group Eand group F.（2）Male were significantly more than females in the patients whose right adrenal vein openings in the A,B,C,D group,and female were significantly more than males in the patients whose right adrenal vein openings in the group E and F.The height of patients in the A,B,C,D group were significantly higher than that of the E group.The body mass index of patients in the group A was significantly higher than that of C,D and E group.The body mass index of patients in the group B,C and D was significantly higher than that of E group.The abdominal circumference of patients in the group A was significantly higher than that of group E and F.The abdominal circumference of patients in the group B,C and D was significantly higher than that of group E.The difference between other groups of gender,height,BMI and abdominal circumference were not found statistically significant.（3）There was no statistical significance of distribution in different age,ethnic differences between the right adrenal vein openings.Conclusion Comprehensive evaluation of sex,height,body mass index,waist circumference contribute to locating the right adrenal vein opening position.