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中华腔镜泌尿外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (02) : 186 -191. doi: 10.3877/cma.j.issn.1674-3253.2023.02.019

综述

无创诊断方法在原发性醛固酮增多症分型诊断中的应用及研究进展
季瑞冬1, 卢振权1,(), 罗兵锋1, 侯健1, 董汝男1, 廖苏才1, 罗光彦1, 梁伟2, 张可可2, 郭敏姗2, 卢捷娜3, 吴旻3, 杨伟洪4   
  1. 1. 518053 深圳,香港大学深圳医院外科部
    2. 518053 深圳,香港大学深圳医院内分泌科
    3. 518053 深圳,香港大学深圳医院心内科
    4. 518053 深圳,香港大学深圳医院介入科
  • 收稿日期:2022-11-10 出版日期:2023-04-01
  • 通信作者: 卢振权

Application and research progress of noninvasive diagnosis in the subtype classification of primary aldosteronism

Ruidong Ji1, Zhenquan Lu1(), Bingfeng Luo1   

  • Received:2022-11-10 Published:2023-04-01
  • Corresponding author: Zhenquan Lu
引用本文:

季瑞冬, 卢振权, 罗兵锋, 侯健, 董汝男, 廖苏才, 罗光彦, 梁伟, 张可可, 郭敏姗, 卢捷娜, 吴旻, 杨伟洪. 无创诊断方法在原发性醛固酮增多症分型诊断中的应用及研究进展[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(02): 186-191.

Ruidong Ji, Zhenquan Lu, Bingfeng Luo. Application and research progress of noninvasive diagnosis in the subtype classification of primary aldosteronism[J]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(02): 186-191.

原发性醛固酮增多症(primary aldosteronism,PA)是继发性高血压的常见病因之一,全球患病率为5%~12%[1]。分型诊断是PA诊断中的关键点及难点。按照病因的不同,PA分为6型,主要包括醛固酮瘤(aldosterone-producing adenoma,APA)、原发性肾上腺皮质增生(又称单侧肾上腺增生) (primary or unilateral hyperplasia,PAH/UNAH)、特发性醛固酮增多症(idiopathic hyperaldosteronism,IHA)、分泌醛固酮的肾上腺皮质癌、异位醛固酮分泌瘤以及家族性醛固酮增多症(familial hyperplasia,FH)。不同分型以及优势分泌侧决定了不同的治疗方案,通常IHA、FH以药物治疗为主,APA及UNAH则首选手术治疗。指南推荐肾上腺静脉采血(adrenal venous sampling,AVS)为分型诊断的首选检查[2]。但AVS为有创操作,并且成本昂贵,技术要求高,这限制了其在临床上的广泛应用[3]。因此,大多数基层医院仍使用无创方法对PA进行分型诊断。本文就现有的无创分型诊断方法在临床的应用及进展进行综述,供临床工作者参考。

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