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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

25卷

期数:

2019年01期

页码:

59-62

栏目:

临床医学

出版日期:

2019-01-20

文章信息/Info

Title:

Diagnostic value of adrenal venous sampling in primary aldosteronism

文章编号:

1006-8147(2019)01-0059-04

作者:

范中强; 费夏俊; 林 毅

（天津医科大学总医院泌尿外科，天津300070）

Author(s):

FAN Zhong-qiang;  FEI Xia-jun;  LIN Yi

（Department of Urology, General Hospital, Tianjin Medical University, Tianjin 300070, China）

关键词:

肾上腺静脉取血术; 诊断价值; 原发性醛固酮增多症

Keywords:

adrenal vein sampling;  diagnostic value;  primary aldosteronism

分类号:

R69

DOI:

-

文献标志码:

A

摘要:

目的：探讨肾上腺静脉取血术(AVS)在原发性醛固酮增多症(PA)患者临床诊断中的价值。方法：回顾我院2015年5月-2017年5月收治的38例PA患者，分为单侧肾上腺微结节组、双侧肾上腺增厚组及双侧肾上腺单发性大结节组，对此3组患者的AVS检查结果进行统计学分析，金标准设定为病理检查结果。结果：单侧肾上腺微结患者组，AVS诊断肾上腺腺瘤患者18例，病理证实腺瘤患者17例，增生1例，符合率为94.4%（17/18），P＜0.01；AVS诊断增生患者4例，符合率为75.0%（3/4），P＜0.01。双侧肾上腺增厚患者组，AVS诊断腺瘤患者4例，符合率为75.0%（3/4）P＜0.05；AVS诊断增生患者8例，符合率为87.5%（7/8）P＜0.05。双侧肾上腺单发性大结节患者中，AVS诊断腺瘤患者3例，增生1例，符合率为100%（4/4）P＜0.05。结论：AVS检查在单发性肾上腺微结节的PA患者中具有一定的辅助诊断作用，但非临床所必需；在双侧肾上腺增厚的PA患者的早期诊断及治疗具有重要意义；在双侧肾上腺单发性大结节的PA患者的手术侧别选择中提供一定的帮助。

Abstract:

Objective: To explore the diagnostic value of adrenal venous sampling in primary aldosteronism. Methods: We reviewed 38 cases of PA patients who were admitted to our hospital from May 2015 to May 2017. The patients were divided into adrenal microtubercle microtubercle group, bilateral adrenal nodule group and bilateral adrenal single tuberosity group, the results of the AVS examination in the three groups were statistically analyzed, and the gold standard was set as pathological examination result. Results: Among adrenal microtubercle patients, 18 cases of adrenal adenoma were diagnosed by AVS, 17 cases of adenoma and 1 case of hyperplasia were confirmed by pathology, and the coincidence rate of AVS was 94.4% （17/18）， P＜0.01; four cases of hyperplasia were diagnosed by AVS, and the coincidence rate of AVS was 75.0% （3/4），P＜0.01. In bilateral adrenal nodule group, 4 cases of adenoma were diagnosed by AVS, and the coincidence rate of AVS was 75.0%(3/4), P＜0.05； eight patients of hyperplasia were diagnosed by AVS, and the coincidence rate of AVS was 87.5% （7/8）, P＜0.05. In the four patients with bilateral adrenal single tuberosity, 3 cases of adenoma and 1 case of hyperplasia were diagnosed by AVS, with the coincidence rate of 100%(4/4), P＜0.05. Conclusion: The AVS examination has a certain auxiliary diagnostic function in the adrenal microtubercle patients with primary aldosteronism, and has a great significance in the differential diagnosis and treatment of the patients with bilateral adrenal thickening, which can help select patients with bilateral adrenal nodules before surgery.

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备注/Memo

备注/Memo:

作者简介 范中强（1989-），男，硕士在读，研究方向：泌尿外科；通信作者：林毅，E-mail:linyi6312@163.com。

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更新日期/Last Update: 2019-03-01