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在干扰药物开启和关闭期间查原发性阿尔多斯特主义
Xiaoyu Li1, Jiayu Liang1, Jinbo Hu1
1Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Endocrine
|October 5, 2023
概括
抗高血压药物对原发性阿尔多斯子症 (PA) 查的阿尔多斯素与素比率 (ARR) 准确性影响最小. 将ARR值降低到10 pg/μIU可以在患者服用干扰药物时保持诊断性能.
科学领域:
- 内分泌学 在内分泌学.
- 临床诊断 临床诊断 临床诊断
- 高血压管理 高血压管理
背景情况:
- 原发性阿尔多斯特隆症 (PA) 是二次高血压的常见原因之一.
- 精确的PA查对于及时诊断和治疗至关重要.
- 阿尔多与的比率 (ARR) 是一个关键的查生物标志物,但它的准确性可能会受到抗高血压药物的影响.
研究的目的:
- 评估抗高血压药物干扰对原发性阿尔多斯特症 (PA) 的阿尔多斯特与雷宁比率 (ARR) 诊断准确性的临床相关性.
- 在服用抗高血压药物的患者中,确定PA查的最佳ARR值.
主要方法:
- 追溯和前性队列包括患有PA和基本高血压 (EH) 的患者.
- 使用确认性测试来诊断PA.
- 计算了受体运行特征曲线 (AUC) 下的面积,ARR的灵敏度和特异性,使用和不使用干扰药物.
主要成果:
- 在服用和不服用干扰药物的患者之间,ARR的AUC是可比的 (追溯:0.82与0.87;前:0.78与0.84).
- 在20ppg/μIU的值下,ARR敏感性较低,对干扰药物的特异性更高.
- 将ARR值降低到10 pg/μIU,导致灵敏度和特异性与干扰药物的灵敏度和特异性相当.
结论:
- 在服用干扰性抗高血压药物的患者中,使用ARR对PA的查是可行的.
- 当患者服用干扰药物时,建议将ARR值降至10 pg/μIU.
- 这种调整确保了可靠的PA查,在大多数情况下不需要取消药物治疗.
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