【醛固酮产生性腺瘤患者血浆肾素浓度分布特点】。

J Y Liang, Y Jing, H Shen, X J Chen, W J Luo, Y Song, Y Wang, J B Hu, S M Yang, F F Wu, Q F Li
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摘要

目的:分析醛固酮生成性腺瘤(APA)患者血浆肾素浓度(PRC)的分布特征及其对诊断的影响。方法:回顾性分析200例APA患者的临床资料(男性80例,女性120例;对2013年11月至2022年1月在重庆医科大学第一附属医院住院的患者(平均年龄45.6岁)进行评估。采用自动化学发光免疫分析法测定PRC。分析PRC的分布特征,并以8.2 mU/L作为低肾素临界值评价肾素是否被抑制。结果:中位PRC为1.6 mU/L(范围0.4 ~ 41.5 mU/L)。在8.0%(16/200)的APA患者中,PRC≤2 mU/L的有116例,28.2 mU/L的有41例。2.5%(5/200)的APA患者PRC未被抑制,导致原发性醛固酮增多症筛查结果阴性。结论:尽管大多数APA患者的PRC较低,但仍有少数(8%)患者的PRC未被完全抑制,这可能导致在原发性醛固酮增多症筛查中漏诊。虽然原发性醛固酮增多症高度可疑,但需要进一步调查以确定诊断,即使PRC在筛查时未被完全抑制。
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[Distribution characteristics of plasma renin concentration in patients with aldosterone-producing adenoma].

Objective: To analyze the distribution characteristics of plasma renin concentration (PRC) in patients with aldosterone-producing adenoma (APA) and its impact on diagnosis. Methods: In this retrospective case series, clinical data from 200 patients with APA (80 men and 120 women; mean age 45.6 years) in the First Affiliated Hospital of Chongqing Medical University from November 2013 to January 2022 were evaluated. PRC was determined by automated chemiluminescence immunoassay. The distribution characteristics of PRC were analyzed, and 8.2 mU/L was used as the low renin cutoff to evaluate whether renin was suppressed. Results: The median PRC was 1.6 mU/L (range, 0.4-41.5 mU/L). There were 116 patients with APA with PRC of ≤2 mU/L, 41 patients with 28.2 mU/L) in 8.0% (16/200) of the patients with APA. And PRC was not suppressed in 2.5% (5/200) of the patients with APA, resulting in a primary aldosteronism negative screening outcome. Conclusions: Although most patients with APA have low PRC, there are a small number (8%) of patients whose PRC has not been fully suppressed, which can lead to missed diagnoses during primary aldosteronism screening. While primary aldosteronism is highly suspected, further investigations are required to determine the diagnosis, even if PRC is not fully suppressed at screening.

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