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专家共识关于初级阿尔多子症严重性分类及其在指示上腺静脉采样中的战略应用
Masanori Murakami1, Mitsuhide Naruse2, Hiroki Kobayashi3
1Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo 113-8510, Japan.
开发了一种新的初级阿尔多斯特症严重程度分类 (PASC) 来分类疾病严重程度. PASC与PA亚型相关,有助于对上腺静脉采样等侵入性诊断的决策.
科学领域:
- 内分泌学 在内分泌学.
- 高血压研究 高血压研究
- 临床诊断 临床诊断 临床诊断
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.
- 目前的PA管理缺乏标准化的严重程度等级,阻碍了临床决策.
- 侵袭性诊断,如上腺静脉采样 (AVS),通常需要用于PA.
研究的目的:
- 开发一种基于全球专家共识的AP严重程度分类.
- 改进PA诊断,治疗和随访的临床决策.
- 建立一个工具,帮助确定AVS的需求.
主要方法:
- 使用德尔菲方法与来自40个中心的45名国际专家合作.
- 在四轮中开发了初级阿尔多斯特罗尼症严重性分类 (PASC).
- 在26个中心的2593名PA患者中,追溯应用了PASC.
主要成果:
- 建立了PASC,整合了血清,血压和基底血中阿尔多斯特的度.
- 分类PA为轻度 (3-4分),中度 (5-7分) 和严重 (8-9分).
- 观察到PASC严重程度与侧向PA亚型流行率之间的一致性.
结论:
- PASC是一种简化,半定量化的PA严重性分类.
- PASC与横向的PA亚型相关.
- 在考虑手术之前,PASC可以指导对AVS的分级建议.
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