摘要
目的 探讨肾上腺静脉采血在原发性醛固酮增多症(PHA)患者中的诊治价值。方法 选取确诊PHA患者27例进行肾上腺静脉采血(AVS)检查,比较肾上腺静脉与外周静脉及下腔静脉皮质醇、醛固酮水平及优势侧比率、采血成功率等指标。结果 AVS成功采血患者的肾上腺静脉血清皮质醇及醛固酮水平均明显高于外周血清及下腔静脉血清水平(P<0.05),而外周血清与下腔静脉血清的皮质醇及醛固酮差异无统计学意义(P>0.05)。单侧肾上腺腺瘤的病变同侧优势率为50%,双侧肾上腺腺瘤的单侧优势率为66.67%,肾上腺正常的患者单侧优势率为42.86%。AVS采血中,左侧肾上腺静脉采血成功率高于右侧肾上腺静脉采血成功率,经肘正中静脉穿刺成功率高于经股静脉采血成功率,但差异无统计学意义(P>0.05)。结论 AVS能更准确反映醛固酮分泌水平,为PHA分型诊断的良好补充,可以指导PHA患者的精准治疗,为患者带来最大获益。
Objective To explore the diagnostic and therapeutic value adrenal venous blood sampling in the patients with primary hyperaldosteronism(PHA).Methods 27 patients with PHA were selected and the adrenal venous blood sampling(AVS)were performed.The levels of cortisol and aldosterone, the ratio of dominant side and the success rate of blood collection in the adrenal vein, peripheral vein and inferior vena cava were compared.Results The levels of cortisol and aldosterone in adrenal vein serum of patients with successful AVS were significantly higher than those in peripheral and inferior vena cava serum(P<0.05),but there was no significant difference in cortisol and aldosterone between peripheral and inferior vena cava serum(P>0.05).The ipsilateral dominance rate of unilateral adrenal adenoma was 50%,that of bilateral adrenal adenoma was 66.67%,and that of patients with normal adrenal gland was 42.86%.The success rate of left AVS was higher than that of right AVS,and the success rate of puncture through the middle elbow vein was higher than that of femoral vein, but there was no statistical difference(P>0.05).Conclusion AVS can more accurately reflect the level of aldosterone secretion, which is a good supplement for the classification and diagnosis of PHA.It can guide the accurate treatment of patients with primary aldosteronism and bring maximum benefits to patients.
作者
雷海芳
马金莲
马志刚
马云海
牛涛
陈芳
LEI Haifang;MA Jinlian;MA Zhigang;MA Yunhai;NIU Tao;Chen Fang(Department of Cardiology,the First People′s Hospital of Yinchuan,Yinchuan 750001,China)
出处
《宁夏医学杂志》
CAS
2022年第10期907-910,共4页
Ningxia Medical Journal
基金
宁夏科技厅重点研发计划项目(2019BEG03015)。
