摘要
目的探讨血浆醛固酮/肾素活性比值(ARR)在原发性醛固酮增多症(PA)的应用分析。方法选取2016年1月至2017年12月在驻马店市中心医院治疗的PA患者78例(PA组),同时选取疑似PA但确诊为原发性高血压(EH)患者120例(EH组),比较两组临床一般资料以及卧位、立位ARR水平。方法 PA组收缩压、舒张压和尿钾分别为(162.20±20.03)mmHg、(103.20±12.23)mmHg和(37.18±9.39)mmol/L,明显高于EH组(P<0.05),而血钾为(3.02±0.55)mmol/L,明显低于EH组(P<0.05);PA组卧位、立位ARR分别为73.01(42.23,120.03)ng·dl-1/ng·ml-1·h-1和60.10(30.12,220.43)ng·dl-1/ng·ml-1·h-1,明显高于EH组(P<0.05);卧位ARR和立位ARR诊断PA的ROC曲线下面积分别为0.910和0.946(P<0.05),卧位ARR和立位ARR截断值分别为15.96ng·dl-1/ng·ml-1·h-1和32.96ng·dl-1/ng·ml-1·h-1,灵敏度分别为94.90%和100.00%,特异度分别为80.83%和81.67%。结论血浆ARR筛查PA有重要作用,其中立位ARR筛查诊断的价值可能较高,值得进一步研究。
Objective To investigate the application of plasma aldosterone/renin activity ratio (ARR) in primary aldosteronism (PA). Methods Seventy-eight cases of PA patients (PA group) who were treated in Zhumadian Central Hospital from January 2016 to December 2017 were selected, and 120 cases (EH group) who were diagnosed as primary hypertension (EH) with suspected PA were selected. The general clinical data and the ARR level of lying position and standing position were compared between the two groups. Results The systolic pressure, diastolic pressure and urinary potassium in the PA group were (162.20±20.03) mmHg,(103.20±12.23) mmHg and (37.18±9.39) mmol/L, which were significantly higher than those in the EH group (P<0.05). However, the blood potassium (3.02±0.55 mmol/L) was significantly lower than that of the EH group (P<0.05).In PA group, the lying position and standing position ARR were 73.01 (42.23120.03) ng·dl-1/ng·ml-1·h-1 and 60.10 (30.12220.43) ng·dl-1/ng·ml-1·h-1, which were significantly higher than those in EH group (P<0.05). The area under the ROC curve of the lying position ARR and the standing position ARR for diagnosing PA were 0.910 and 0.946 (P<0.05). The cut-off values of lying position ARR(sensitivity:94.90%, specificity:80.83%) and the standing position ARR(sensitivity:100.00%, specificity:81.67%) were 15.96 ng·dl-1/ng·ml-1·h-1 and 32.96 ng·dl-1/ng·ml-1·h-1. Conclusion Plasma ARR plays an important role in screening PA, and the diagnostic value of the standing position ARR may be higher, which deserve further study.
作者
杨小东
刘成功
李万森
田艳娟
高大红
马海丽
高毅娜
胡艳红
翁孝刚
Yang Xiaodong;Liu Chenggong;Li Wansen;Tian Yanjuan;Gao Dahong;Ma Haili;Gao Yina;Hu Yanhong;Wen Xiaogang(Department of General Medicine, Zhumadian Central Hospital, Zhumadian 463000,Henan province, China;Third Affiliated Hospital of Xinxiang Medical College, Xinxiang 453000, Henan province, China)
出处
《实验与检验医学》
CAS
2019年第5期779-781,共3页
Experimental and Laboratory Medicine
基金
河南省科技厅科技计划项目，编号：072300450370
