原发醛固酮增多症亚型实验室检验结果分析

目的分析原发醛固酮增多症不同亚型的实验室检查结果差异。方法 92例原发醛固酮增多症患者,依据术后组织病理结果分为肾上腺腺瘤组（76例）和肾上腺增生组（16例）,比较2组血钾、血钠、血醛固酮、肾素、血管紧张素Ⅱ和醛固酮肾素比值。结果增生组血钾水平（（3.78±0.38）mmol/L）高于腺瘤组（（3.34±0.66）mmol/L）（P〈0.05）,血钠、血醛固酮、肾素、血管紧张素Ⅱ及醛固酮肾素比值（（143.61±2.45）mmol/L、13.5（6.8,245.0）ng/（L·h）、（0.66±0.72）mg/L、（36.90±23.37）ng/L、170.0（7.7,9 450.0））与腺瘤组（（144.53±3.16）mmol/L、21.2（2.1,375.0）ng/（L·h）、（0.62±1.23）mg/L、（33.84±24.51）ng/L、111.0（2.1,6 820.0））比较差异无统计学意义（P〉0.05）。结论原发醛固酮增多症肾上腺腺瘤和肾上腺增生患者临床表现相似,术前检测血钾有助于亚型判定。

Comparative analysis of laboratory test results of subtypes of primary aldosteronism

Objective To analyze the differences of laboratory test results of the subtypes of primary aldosteronism.Methods Ninety-two patients with primary aldosteronism were divided into adrenal adenoma group（n=76）and adrenal hyperplasia group（n=16）.The levels of blood potassium,sodium,serum aldosterone,renin,angiotensin Ⅱ and aldosterone/plasma renin activity ratio were compared between two groups.Results The level of blood potassium was（3.78±0.38）mmol/L in adrenal hyperplasia group,significantly higher than that in adrenal adenoma group（（3.34±0.66）mmol/L）（P〈0.05）.There were no significant differences in the levels of blood sodium,serum aldosterone,renin,angiotensinⅡ and aldosterone/plasma renin activity ratio between adrenal hyperphasia group（（143.61±2.45）mmol/L,13.5（6.8,245.0）ng/（L·h）,（0.66±0.72）mg/L,（36.90±23.37）ng/L,170.0（7.7,9 450.0））and adrenal adenoma group（（144.53±3.16）mmol/L,21.2（2.1,375.0）ng/（L·h）,（0.62±1.23）mg/L,（33.84±24.51）ng/L,111.0（2.1,6 820.0））（P〈0.05）.Conclusion Adrenal hyperplasia and adrenal adenoma have similar clinical manifestations in patients with primary aldosteronism,and preoperative detection of serum potassium helps to judge the subtypes.