血浆醛固酮2f肾素活性比值在原发性醛固酮增多症筛查诊断中的临床应用

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1、大连医科大学硕士学位论文ClinicalsignificanceofaldosteronetoreninratioinscreeningprimaryaldosteronismMasterdegreecandidate：BaishuangZhangSupervisor：ProfessorYanLuVice—supervisor：ProfessorYinongJiangMajor：InternalMedicineAbstractObjective：Inrecentyears，theassessment

2、oftheplasmaaldostemne—to-reninratio(ARR)hasbecomeaeveryeffectiveandwidelyusedmethodforscreeningprimaryaldosteronismfromhypertensives．ItiswellknownthatthereisalargevarianceinARRvaluebetweendifferentracesandregion，MeanwhileARRCanbeaffectedbymanyfactors，s

3、uchasdrugs，postureanddetectiontimeetc．Thereceiveroperatingcharacteristic(ROC)curvewasusedtoevaluatethevalueofaldosteronetoreninratio(ARR)inscreeningprimaryaldosteronism．Methods：TheclinicaldataofARRinsupineanduprightpositionswerecollectedfrom301patients

4、whoissuspectedhasprimaryaldosteronismduringMarch2012toSeptember2013．supineanduprightARRdetectionandSalineinfusiontestwereperformedforalltheparticipants．105patientswerediagnosedprimaryaldosteronismand196patientswereessentialhypertensionamongallparticipa

5、nts．Gender，age，thecourseofhypertension，BMI，systolicbloodpressure，diastolicbloodpressure，serumsodium，potassium，urinarysodium，urinarypotassium，supinePRA，uprightPRA，supinePAC，uprightclinicaldataPAC，supineARR，uprightARRwerecollectedforstatisticalanalysis．A

6、tlastusetheROCcurvetodefinethebestcut-offvalueofARRforscreeningprimaryaldosteronismfromhypertensives．Results：IntheanalysisoftheclinicaldataofPAgroupandEHgroup，Wefindtheiteamsofsupine／uprightPAC，ARRlevelsinEHgroupwerelowerthanthatofPAgroup，andthesupine／

7、uprightplasmaPRAWashigherthanthatofPAgroup，thedifferencebothhavestatisticalsignificance((P<0．05)；theareaundertheROCcurveofsupineARRis0．7633大连医科大学硕士学位论文(0．717—0．813)，theareaundertheROCcurveofuprightARRis0．909(0．868—0．941)，therewassignificantlydifference

8、betweenthesetwoareasundertheROCcurve(P<0．01)；theareaundertheROCcurveofuprightPRAisO．814(0．762—0．859)，theareaundertheROCcurveofuprightPACisO．684(0．625-0．074)，therewassignificantlydifferencebetweenthesetwoareasundertheROCcurve(P