在患有动脉狭窄和阿尔多斯特主义的患者中,阿尔多斯特与雷宁比率的变化
Qian Wang1, Hui Dong1, Hongwu Li1
1Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Journal of clinical hypertension (Greenwich, Conn.)
|March 11, 2025
概括
恶性高血压和严重的动脉狭窄症 (RAS) 可能导致错误负的初级阿尔多斯学 (PA) 查. 在RAS治疗后仔细分析和重新测试对于准确的PA诊断至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管医学 心血管医学
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.
- 动脉狭窄 (RAS) 也可能导致二次高血压,并可能与PA共存.
- 阿尔多与的比率 (ARR) 是PA的关键查测试,但其准确性可能会受到其他条件的影响,如RAS.
研究的目的:
- 在患有动脉狭窄症 (RAS) 和原发性阿尔多斯特症 (PA) 患者中研究阿尔多斯特与因因比率 (ARR) 的变化.
- 确定影响阿尔多与因比 (ARR) 的因素,并导致RAS患者的错误阴性PA查结果.
- 评估恶性高血压和RAS严重程度对PA查的影响.
主要方法:
- 在2016年1月至2021年12月期间,对78名RAS和PA患者进行了回顾性队列研究.
- 根据标准化PA查,患者被分为ARR阳性和ARR阴性组.
- 使用二进制逻辑回归分析来识别与RAS存在的假负PA结果相关的因素.
主要成果:
- 与ARR阴性组相比,ARR阳性组在恶性高血压 (2.4%对27.8%),第三阶段高血压 (81.0%对97.2%) 和RAS程度 (64.3%对71.8%) 中显示出显著差异.
- 恶性高血压 (OR, 15.250) 和RAS程度 (OR, 1.034) 是假阴性PA结果的显著预测因素.
- 53.8%的患者是ARR阳性,而46.2%是ARR阴性.
结论:
- 恶性高血压和严重的RAS可能会导致初级阿尔多斯顿症查中的假阴性结果.
- 在RAS患者中,需要仔细解释ARR结果.
- 建议在RAS治疗后重新检查PA查测试以确认诊断.
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