摘要
目的研究盐水负荷试验后醛固酮(PAC)/血钾在预测原发性醛固酮增多症(PA)分型方面的作用。方法选取郑州大学第一附属医院2020年8月至2022年3月收治的完成肾上腺静脉采血(AVS)检查的PA患者共计113例。按照AVS结果分为双侧PA组和单侧PA组。研究两组间血钾、PAC等指标的差异,并分析单侧PA与血钾、PAC等检测指标的相关性。logistic回归分析探讨预测单侧PA的独立因素。受试者工作特征(ROC)曲线分析上述指标对单侧PA的预测价值。结果与双侧PA组相比,单侧PA组的血钾水平较低,年龄较轻,醛固酮相关指标均较高。相关分析显示,血钾与单侧PA呈负相关;和醛固酮有关的指标,与单侧PA均呈正相关。logistic回归分析显示血钾和(OR=0.091,95%CI 0.021~0.388,P=0.001)盐水后PAC(OR=1.004,95%CI 1.000~1.008,P=0.040)是预测单侧PA的独立预测因子。ROC分析相关因素对单侧PA预测价值:血钾曲线下面积0.765(0.691~0.827)、盐水后PAC曲线下面积0.828(0.785~0.932)、盐水后PAC/血钾曲线下面积0.872(0.803~0.942)。结论盐水后PAC/血钾在预测单侧PA方面,可能是一项简单有效的指标。若该比值>8.7(ng·dL^(-1))/(mmol·L^(-1)),预示单侧PA可能性大。
Objective To study the role of post-SIT plasm aldosterone concentration(PAC)/potassium ratio in predicting primary aldosteronism(PA)subtype.Methods A total of 113 patients with PA who completed adrenal vein sampling(AVS)examination were enrolled in the First Affiliated Hospital of Zhengzhou University from August 2020 to March 2022.According to AVS results,they were divided into bilateral PA group and unilateral PA group.The differences of serum potassium and PAC between the two groups were studied,and the correlation between unilateral PA and serum potassium and PAC were analyzed.Logistic regression analysis was used to investigate the independent factors for predicting unilateral PA.ROC curve was used to analyze the predictive value of the above indexes for unilateral PA.Results Compared with bilateral PA group,unilateral PA group had lower serum potassium level,younger age and higher aldosterone-related indexes.Correlation analysis showed that blood potassium was negatively correlated with unilateral PA.The indices related to aldosterone were positively correlated with unilateral PA.Logistic regression analysis showed that serum potassium(OR=0.091,95%CI 0.021-0.388,P=0.001)and post-SIT PAC(OR=1.004,95%CI 1.000-1.008,P=0.040)were independent predictors of unilateral PA.The predictive value of ROC curve analysis of related factors for unilateral PA was as follows:AUROC of potassium was 0.765(0.691-0.827),post-SIT PAC was 0.828(0.785-0.932),post-SIT PAC/potassium ratio was 0.872(0.803-0.942).Conclusion The post-SIT PAC/potassium ratio may be a convenient and useful indicator for predicting unilateral PA.If the ratio is greater than 8.7(ng·dL^(-1))/(mmol·L^(-1)),unilateral PA is possible.
作者
马笑堃
秦贵军
吉鸿飞
王海滨
赵霖
MA Xiaokun;QIN Guijun;JI Hongfei;WANG Haibin;ZHAO Lin(Department of Endocrinology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2023年第21期3852-3856,共5页
Henan Medical Research
基金
国家自然科学基金(81974110)。
