醛固酮腺瘤患者血浆醛固酮、肾素水平分析  

Plasma aldosterone and renin levels in patients with aldosterone adenoma

作　　者：常富江 张雪培[2] 王声政[2] 陶金[2] 付天龙 CHANG Fujiang;ZHANG Xuepei;WANG Shengzheng;TAO Jin;FU Tianlong(Department of Urology,People's Hospital of Zhengzhou,Zhengzhou 450003,Henan,China;Department of Urology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450002,Henan,China;Department of Urology,Zhengzhou Central Hospital,Zhengzhou 450007,Henan,China)

机构地区：[1]郑州人民医院泌尿外科,河南郑州450003 [2]郑州大学第一附属医院泌尿外科,河南郑州450002 [3]郑州市中心医院泌尿外科,河南郑州450007

出　　处：《检验医学》2019年第8期722-725,共4页Laboratory Medicine

摘　　要：目的探讨化学发光免疫法(CLIAS)检测血浆醛固酮、肾素对醛固酮腺瘤(APA)的筛查价值。方法选取确诊为APA并经手术治疗的患者79例及确诊为原发性高血压(EH)的患者96例,采用CLIAS检测所有患者血浆醛固酮、肾素水平。比较APA患者术前、术后血浆醛固酮、肾素水平及醛固酮/肾素比值(ARR)。采用受试者工作特征(ROC)曲线评价ARR诊断APA的性能。结果APA组血浆醛固酮水平及ARR明显高于EH组(P<0.05)、血浆肾素水平明显低于EH组(P<0.05)。ROC曲线分析结果显示,立位ARR诊断APA的曲线下面积为0.938,最佳临界值为42.8,敏感性为98.0%,特异性为91.6%,约登指数为0.896。与术前比较,APA患者术后立位醛固酮水平明显降低(P<0.05),肾素水平明显升高(P<0.05),ARR明显下降(P<0.001)。结论CLIAS可作为血浆肾素、醛固酮检测的有效方法,在APA筛查中具有重要价值。Objective To investigate the role of chemiluminescence immunoassay(CLIAS)for determining plasma aldosterone and renin for screening aldosterone-producing adenoma(APA).Methods A total of 79 patients with APA and 96 patients with essential hypertension(EH)were enrolled,and plasma aldosterone and renin levels were determined by CLIAS.Plasma levels of aldosterone and renin and aldosterone to renin ratios(ARR)before and after operation were compared.Receiver operating characteristic(ROC)curve was used to evaluate the performance of ARR for the diagnosis of APA.Results The plasma levels of aldosterone and ARR in APA group were higher than those in EH group(P<0.05),and plasma renin levels were lower than those in EH group(P<0.05).ROC curve analysis showed that the area under the curve of orthostatic ARR was 0.938,the optimal cut-off value was 42.8,the sensitivity was 98.0%,the specificity was 91.6%,and the Youden index was 0.896.Postoperative aldosterone levels were lower(P<0.05),renin levels were higher(P<0.05),and ARR was lower(P<0.001)compared with those before operation.Conclusions CLIAS can be used in determining plasma aldosterone and renin.

关 键 词：醛固酮 肾素 原发性醛固酮增多症 化学发光免疫法 醛固酮腺瘤 

分 类 号：R446.1[医药卫生—诊断学]