目的评估卡托普利试验(captopril suppression test,CAPT)对原醛症(primary aldosteronism,PA)及原发性高血压(essential hypertension,EH)患者血醛固酮水平的抑制程度,并与正常血压的志愿者比较,探讨CAPT诊断PA的最适醛固酮水平,并分析饮食中钠盐摄入量是否对CAPT结果有影响。方法选择符合PA筛查标准的高血压患者作为本研究对象,同时纳入12例血压正常的健康人作为正常对照。采血检测血清醛固酮和血浆肾素活性,准确留取24h尿液并同步检测血钠及尿钠水平。按照标准试验流程行CAPT。结果本研究共纳入76例受试者,其中PA 41例,EH 23例,正常对照12例。CAPT诊断PA的ROC曲线下面积为0.915(P<0.001),服药后诊断PA的最适醛固酮值为16.725ng/dL,对应的敏感性和特异性分别为82.9%和94.3%。服药后PA组醛固酮较基线仅下降17.4%,其中醛固酮瘤组与特醛症组血清醛固酮分别下降15.2%与21.1%。23例EH患者服药后血清醛固酮较基线仅下降10.6%,其中8例受试者服药前血清醛固酮大于15ng/dL,服药后平均降至14.1ng/dL,较基线下降23.3%。而12例正常对照者服药后血清醛固酮较基线下降47.7%。尿钠排出量的多少对CAPT的结果无明显影响。结论 CAPT诊断PA的敏感性和特异性均较高。但口服卡托普利对中国西南地区原发性高血压患者血清醛固酮的抑制程度低于国外西方人群研究数据。膳食中钠盐摄入量的多少对CAPT结果无明显影响。 Objective To evaluate the inhibitory effect of captopril suppression test (CAPT) on the level of serum aldosterone in patients with primary aldosteronism (PA) and essential hypertension (EH) Were compared to explore the CAPT diagnosis of PA optimal aldosterone levels, and analysis of dietary sodium intake whether CAPT results have an impact. Methods Hypertensive patients who met the PA screening criteria were selected as the study subjects. Twelve healthy normotensive subjects were included as normal controls. Serum aldosterone and plasma renin activity were detected by blood sampling, 24h urine was accurately collected and serum sodium and natriuretic peptide were detected synchronously. Follow the standard test procedure CAPT. Results A total of 76 subjects were enrolled in this study, including 41 PA, 23 EH and 12 normal controls. The area under the ROC curve for diagnosis of PA by CAPT was 0.915 (P <0.001). The optimal value of aldosterone for diagnosis of PA was 16.725ng / dL after administration, corresponding to a sensitivity and specificity of 82.9% and 94.3%, respectively. After treatment, the aldosterone in PA group decreased by only 17.4% compared with baseline. The aldosterone in aldosterone group and special aldosterone group decreased by 15.2% and 21.1% respectively. Serum aldosterone in 23 patients with EH dropped only 10.6% compared with baseline. Serum aldosterone was higher than 15ng / dL in 8 patients and averaged 14.1ng / dL after taking medicine, which was 23.3% lower than baseline. Serum aldosterone in 12 normal controls was 47.7% lower than baseline. The amount of urinary sodium excretion of CAPT results no significant effect. Conclusions The sensitivity and specificity of CAPT in the diagnosis of PA are high. However, the inhibition of oral aldosterone by oral captopril in patients with essential hypertension in southwestern China was lower than that in western countries. The dietary intake of sodium did not have a significant effect on CAPT results.