液相色谱-串联质谱法检测血浆醛固酮和血管紧张素1筛查原发性醛固酮增多症的应用评价

Application Evaluation of Liquid Chromatography-Tandem Mass Spectrometry for Screening Primary Aldosteronism by Detecting Plasma Aldosterone and Angiotensin Ⅰ

目的评价液相色谱-串联质谱法(LC-MS/MS)检测血浆醛固酮和血管紧张素1用于原发性醛固酮增多症(PA)筛查的应用效果。方法建立LC-MS/MS法检测血浆醛固酮和血管紧张素1的检测体系,并进行性能验证。收集疑似PA患者共58例,分别取卧位和立位进行采血检测血浆醛固酮和血管紧张素1,比较LC-MS/MS法与免疫分析法(CLIA)在卧位和立位条件下筛查PA的效能,并进行一致性评价。结果LC-MS/MS法在性能验证中表现出良好的线性、精密度、准确度和定量下限;LC-MS/MS法与CLIA法的结果呈中等程度正相关性;筛查PA时LC-MS/MS法在卧位和立位条件下的曲线下面积均优于CLIA法,特别是在卧位条件下,LC-MS/MS法的AUC达到了0.85,具有相对较高的准确性。结论LC-MS/MS法在筛查PA方面可能具有更高的诊断准确性和临床预测价值,但在实际推广中仍需考虑其设备和操作技术的局限性。

Objective To evaluate the application effectiveness of liquid chromatography-tandem mass spectrometry(LC-MS/MS)for detecting plasma aldosterone and angiotensin Ⅰ in screening primary aldosteronism(PA).Methods We established an LC-MS/MS method to detect plasma aldosterone and angiotensin Ⅰ and conducted performance validation.A total of 58 suspected PA patients were collected,and blood samples were taken in both supine and upright positions to compare the efficiency of LC-MS/MS and chemiluminescent immunoassay(CLIA)in screening PA under these conditions.Consistency was also assessed.Results LC-MS/MS demonstrated good linearity,precision,accuracy,and quantification limits during performance validation.There was a moderate positive correlation between LC-MS/MS and CLIA results.When screening for PA,LC-MS/MS outperformed CLIA,particularly in the supine position,where LC-MS/MS achieved an AUC of 0.85,indicating relatively high accuracy.Conclusion LC-MS/MS may offer higher diagnostic accuracy and clinical predictive value in screening for PA.However,its equipment and operational limitations should be considered during practical implementation.