SUSPPUP指数在原发性醛固酮增多症诊断中的价值  

Application of SUSPPUP ratio in patients with primary aldosteronism

作　　者：孔剑琼 李南方 祖菲亚 张德莲 常桂娟 

机构地区：[1]新疆自治区人民医院高血压中心,新疆高血压研究所,乌鲁木齐830001

出　　处：《中华内分泌代谢杂志》2014年第7期587-591,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金资助项目（81260129）

摘　　要：目的 评估SUSPPUP指数（血钠与尿钠的比值除以血钾平方与尿钾的比值）在原发性醛固酮增多症（PA）筛查中的作用.方法 对952例高血压患者进行坐位血浆肾素活性（PRA）及醛固酮浓度（PAC）的检测,根据PA初筛标准及盐水负荷试验标准,筛查出PA组204例和排除PA的原发性高血压组261例,比较两组尿钾/尿钠、SUSPPUP指数和PAC/PRA比值（ARR）等指标的差异.构建和比较尿钾/尿钠、SUSPPUP指数和ARR对诊断PA的ROC曲线.结果 SUSPPUP曲线下面积0.797,与ARR曲线下面积相当（0.796）.SUSPPUP的最佳切点为1.0,敏感性和特异性分别达到98.9％和81％.结论 SUSPPUP可以作为快速筛查PA一个价格不高的指标.Objective To assess the effectiveness of the quotient of serum sodium to urinary sodium divided by （serum potassium） 2 to urinary potassium （SUSPPUP） in screening for primary aldosteronism （PA）.Methods Among 952 patients with hypertension who had renin activity,aldosterone measurements and concomitant serum and urinary biochemistry data,204 patients were diagnosed as cases of PA and 261 as cases of essential hypertension.Diagnosis of PA was made in accordance with established laboratory criteria including renin activity and aldosterone,plasma aldosterone concentration/plasma renin activity （ARR）,and saline loading test.The SUSPPUP ratio with the ARR were compared in two groups.Results The area under the curve of SUSPPUP and ARR was 0.797 and 0.796 respectively according to receiver operating characteristic curve,optimal cutoff of SUSPPUP was 1.0,the sensitivity and specificity of SUSPPUP was 98.9% and 81% respectively.Conclusions The SUSPPUP ratio is an inexpensive and rapid tool to assess the extent of mineralocorticoid excess,therefore,SUSPPUP ratio can be applied to screen PA in hypertensive patients.

关 键 词：原发性醛固酮增多症 高血压 尿钾 血钾 

分 类 号：R586.24[医药卫生—内分泌]