疑诊原发性醛固酮增多症的高血压人群中甘草制剂沾染率的调查  

Investigation on the Contamination Rate of Glycyrrhiza in Hypertension Patients with Suspected Primary Aldosteronism

作　　者：吴锡 赵炼玲[1] 任艳 田浩明[1] 陈涛[1] WuXi;Zhao Lianling;Ren Yan(Adrenal Center,Endocrinology and Metabolism Department,West China Hospital Sichuan University,Chengdu,Sichuan 610041;Department of Endocrinology and Metabolism,Jianyang People's Hospital,Jianyang,Sichuan 641400,China)

机构地区：[1]四川大学华西医院内分泌代谢科,肾上腺疾病诊治中心,四川成都610041 [2]简阳市人民医院内分泌代谢科,四川简阳641400

出　　处：《四川医学》2022年第3期270-273,共4页Sichuan Medical Journal

摘　　要：目的通过检测血浆中的甘草次酸(GA)以评估无明确甘草制剂摄入史的高血压患者进行原发性醛固酮增多症(PA)筛查时的甘草沾染率。方法纳入2019年10月至2020年10月在四川大学华西医院内分泌代谢科住院进行PA筛查及确诊的高血压患者209例,以丙酸睾酮为内标物,采用高效液相色谱法检测患者血浆中的GA。结果4例患者的血浆中检测出GA,甘草沾染率为1.91%,其95%可信区间为(0.0,3.8%)。4例患者中,醛固酮肾素活性比值(ARR)阳性2例,盐水输注试验及卡托普利试验结果提示1例为PA,1例为原发性高血压。结论甘草沾染可能导致PA筛查的假阳性,但进行PA筛查的高血压患者无意识摄入甘草类制剂是小概率事件,临床上可根据病史的询问以排除甘草制剂对筛查试验的影响。Objective Glycyrrhetinic acid(GA)in plasma was measured to assess the rate of glycyrrhetinic acid contamination during screening for primary aldosteronism(PA)in hypertensive patients without a clear history of glycyrrhetinic acid intake.Methods A total of 209 patients with hypertension admitted to the Department of Endocrinology and Metabolism,West China Hospital of Sichuan University from October 2019 to October 2020 for PA screening and diagnosis were enrolled.With testosterone propionate as internal standard,GA in plasma was detected by HIGH-performance liquid chromatography.Results GA was detected in the plasma of 4 patients with a licorice contamination rate of 1.91%with a 95%confidence interval(0.0,3.8%).Among the four patients,two patients were positive for the ratio of aldosterone to renin activity(ARR);the saline infusion test and captopril test suggested that one patient had PA,and the other had essential hypertension.Conclusion Licorice contamination may lead to false-positive in PA screening,but it is a small probability event for hypertension patients undergoing PA screening to ingest licorice preparations unintentionally.Clinically,the influence of licorice preparations on screening tests can be ruled out according to the inquiry of medical history.

关 键 词：原发性醛固酮增多症 甘草 甘草次酸 

分 类 号：R446.11[医药卫生—诊断学]