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目的探讨血浆醛固酮/肾素活性比值(ARR)在原发性高血压患者中筛选原发性醛固酮增多症(PA)的临床价值。方法采用放射免疫法测定320例原发性高血压患者血浆肾素和醛固酮水平并计算ARR。对38例疑诊为PA的病例进行肾上腺薄层CT扫描、病理检查。结果320例患者中有38例患者ARR>50,38例患者再次检测ARR,结果ARR仍>50的34例,PA检出率10.6%(34/320)。34例PA患者肾上腺CT扫描示肾上腺瘤8例,单侧或双侧增生17例;合并低钾血症11例,占32.4%。结论ARR是一个敏感的PA筛查指标,应作为原发性高血压患者尤其是难治性高血压的常规检查项目,ARR在PA诊断中有重要意义,可以提高其诊断率。
Objective To investigate the clinical value of plasma aldosterone / renin activity ratio (ARR) in screening primary aldosteronism (PA) in patients with essential hypertension. Methods Radioimmunoassay was used to determine plasma renin and aldosterone levels in 320 patients with essential hypertension and to calculate ARR. Thirty-eight cases suspected to be PA were examined by adrenal CT scan and pathological examination. Results Among the 320 patients, ARR was found in 38 patients with ARR> 50 and 38 patients. ARR was still detected in 50 and 38 patients, respectively. The detection rate of PA was 10.6% (34/320) in 34 patients. 34 cases of PA patients adrenal CT scan showed adrenal tumor in 8 cases, unilateral or bilateral hyperplasia in 17 cases; hypokalemia in 11 cases, accounting for 32.4%. Conclusion ARR is a sensitive indicator of PA screening and should be used as a routine examination in patients with essential hypertension, especially refractory hypertension. ARR plays an important role in the diagnosis of PA and can improve its diagnosis rate.