本文關(guān)鍵詞：評(píng)價(jià)卡托普利試驗(yàn)診斷原發(fā)性醛固酮增多癥的價(jià)值　出處：《中國(guó)循環(huán)雜志》2016年08期 　論文類(lèi)型：期刊論文

  更多相關(guān)文章： 卡托普利 醛固酮增多癥 醛固酮 診斷切點(diǎn)

【摘要】：目的:評(píng)價(jià)卡托普利試驗(yàn)對(duì)于原發(fā)性醛固酮增多癥的診斷意義,并計(jì)算最佳診斷切點(diǎn)。方法:1994-06至2012-05期間解放軍總醫(yī)院內(nèi)分泌科收治的96例綜合臨床表現(xiàn)、實(shí)驗(yàn)室檢查及輔助檢查明確診斷為原發(fā)性醛固酮增多癥患者為原發(fā)性醛固酮增多癥組,同時(shí)收集45例高度懷疑原發(fā)性醛固酮增多癥,并經(jīng)生化檢查、輔助檢查及功能試驗(yàn)檢查結(jié)果排除原發(fā)性醛固酮增多癥,被診斷為原發(fā)性高血壓的患者為原發(fā)性高血壓組。住院期間患者均行卡托普利試驗(yàn),并應(yīng)用受試者工作特征(ROC)曲線對(duì)卡托普利試驗(yàn)的醛固酮水平及試驗(yàn)后醛固酮與腎素水平進(jìn)行評(píng)價(jià),分析其診斷效能,并得出最佳診斷切點(diǎn)及對(duì)應(yīng)的敏感性和特異性。結(jié)果 :卡托普利試驗(yàn)后1 h、2 h的醛固酮水平的ROC曲線下面積(AUC)為0.831和0.818,試驗(yàn)后1 h、2 h的醛固酮與腎素比值的AUC分別是0.909和0.922;試驗(yàn)后1 h醛固酮水平的切點(diǎn)為544.95 pmol/L,敏感性為70%,特異性為90.7%,試驗(yàn)后2 h醛固酮水平的切點(diǎn)為466.8 pmol/L,敏感性為69.8%;特異性為70.5%;試驗(yàn)后1 h醛固酮與腎素比值的切點(diǎn)為34.6[ng/dl:μg/(ml·h)],敏感性78.3%;特異性88.4%。試驗(yàn)后2 h醛固酮與腎素比值的AUC最大,該指標(biāo)有較高的診斷價(jià)值,診斷切點(diǎn)為42.2[ng/dl:μg/(ml·h)],敏感性和特異性分別為76.7%和95.3%。結(jié)論:卡托普利試驗(yàn)后1 h、2 h后醛固酮水平及醛固酮與腎素的比值均對(duì)原發(fā)性醛固酮增多癥有診斷價(jià)值,以卡托普利試驗(yàn)后2 h醛固酮與腎素比值的診斷價(jià)值最大。
[Abstract]:Objective: to evaluate the diagnostic value of captopril test for primary aldosteronism. Methods 96 cases admitted to the Department of Endocrinology of the General Hospital of PLA from June 1994 to May 2012 were analyzed. Laboratory examination and auxiliary examination confirmed that the patients with primary aldosteronism were diagnosed as primary aldosteronism group. At the same time, 45 cases of highly suspected primary aldosteronism were collected and biochemical examination. The results of auxiliary examination and functional test excluded essential aldosteronism. The patients diagnosed as essential hypertension were treated with captopril test. The aldosterone level of captopril test and the levels of aldosterone and renin after captopril test were evaluated by using the operating characteristics of subjects and the diagnostic efficacy was analyzed. The optimal diagnostic point, sensitivity and specificity were obtained. Results: 1 h after captopril test. The area under the ROC curve of aldosterone level for 2 h was 0.831 and 0.818 respectively. The AUC of aldosterone to renin ratio at 2 h was 0.909 and 0.922, respectively. The cutting point of aldosterone level was 544.95 pmol / L, the sensitivity was 70 and the specificity was 90.7%. 2 h after the trial, the cutting point of aldosterone level was 466.8 pmol / L, and the sensitivity was 69.8 pmol / L; The specificity was 70.5; The ratio of aldosterone to renin was 34.6 at 1 h after the trial. [Ng / dl: 渭 g / ml 路h], sensitivity 78.3; The ratio of aldosterone to renin was the largest in AUC at 2 h after the test. The diagnostic value of this index was high, and the diagnostic cut-off point was 42.2. [The sensitivity and specificity were 76.7% and 95.3, respectively. Conclusion: 1 h after captopril test. The level of aldosterone and the ratio of aldosterone to renin were valuable in the diagnosis of primary aldosteronism 2 h after captopril test.
【作者單位】： 中國(guó)人民解放軍總醫(yī)院老年科;
【分類(lèi)號(hào)】：R586.24
【正文快照】： 卡托普利抑制試驗(yàn)是臨床應(yīng)用最廣泛的原發(fā)性醛固酮增多癥的確診試驗(yàn)之一。正常情況下,卡托普利可以抑制血管緊張素轉(zhuǎn)換酶,減少血管緊張素Ⅱ產(chǎn)生,即使在腎素水平很高的情況下,也可以抑制醛固酮分泌。但對(duì)于自主性分泌醛固酮的原發(fā)性醛固酮增多癥患者,卡托普利對(duì)醛固酮無(wú)明顯抑

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