单侧性原发性醛固酮增多症的预测模型建立及价值评估

Establishment and evaluation of a predicative model in diagnosing unilateral primary aldosteronism

原发性醛固酮增多症(PA)是继发性高血压常见的病因之一,其病因分型诊断的金标准为肾上腺静脉采血(AVS)。本文回顾性分析了2018年7月至2021年8月在南京鼓楼医院内分泌科诊断为PA并行AVS或单侧肾上腺切除手术患者的数据,通过多元logistic回归分析确定了与单侧醛固酮优势分泌相关的因素,并基于这些因素建立了诊断单侧原发性醛固酮增多症(UPA)的预测模型:年龄<40岁,血浆醛固酮浓度(PAC)>15 ng/dL,肾上腺CT示单侧典型腺瘤,自发性低钾血症。该预测模型可使14%的PA患者避免非必要的AVS。

Primary aldosteronism(PA)is a common cause of secondary hypertension,with adrenal vein sampling(AVS)being the gold standard for etiological typing diagnosis.This retrospective study analyzed data from patients diagnosed with PA who underwent AVS or unilateral adrenalectomy at Nanjing Drum Tower Hospital′s Endocrinology Department from July 2018 to August 2021.Using multivariate logistic regression analysis,factors associated with unilateral aldosterone hypersecretion were identified.Based on these factors,a predictive model for diagnosing unilateral primary aldosteronism(UPA)was established:age<40 years,plasma aldosterone concentration(PAC)>15 ng/dL,adrenal CT indicating an unilateral typical adenoma,and spontaneous hypokalemia.This predictive model could help 14%of PA patients avoid unnecessary AVS procedures.