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Effect of Adrenocorticotropic Hormone Stimulation During Simultaneous Bilateral Adrenal Vein Sampling in Primary Aldosteronism
Hormone and Metabolic Research ( IF 2.0 ) Pub Date : 2021-06-21 , DOI: 10.1055/a-1498-6958
Wei Liu 1 , Jingjing Zhang 1 , Yaling Yang 2 , Yinxin Jin 1 , Zaizhao Li 1 , Liting You 1 , Jianguang Luo 3 , Xin Su 1
Affiliation  

The aim of the study was to investigate the significance and influence of adrenocorticotropic hormone (ACTH) stimulation in primary aldosteronism (PA) patients with simultaneous bilateral adrenal vein sampling (AVS). All patients diagnosed with PA underwent simultaneous bilateral AVS with ACTH. In 95 patients, the post-ACTH SI significantly increased (p<0.001), and it gradually decreased from t10–t30 after ACTH stimulation (p<0.001). The unsuccessful catheterization decreased after ACTH stimulation. Time points within 20 min after ACTH stimulation were better for sampling, and the selectivity did not increase over longer periods. According to lateralization before and after ACTH stimulation, the patients could be divided into 3 groups (U, unilateral; B, bilateral): U/U , U/B or B/U, and B/B. Compared with the U/U group, in the U/B or B/U and B/B groups, the lateralization index (LI) was lower both at baseline and after ACTH stimulation (p<0.0001), the contralateral index (CLI) was higher after ACTH stimulation (p<0.003), the serum potassium level was higher (p<0.001), and the carbon dioxide combining power (CO2CP) and base excess (BE) levels were lower. In conclusion, in simultaneous bilateral AVS, ACTH stimulation had significant effects on increasing the catheterization selectivity. Lateralization change was observed after stimulation. After ACTH stimulation, fewer patients could be diagnosed with lateralized PA. Patients with consistent lateralized PA showed a more serious phenotype.

中文翻译:

在原发性醛固酮增多症中同时进行双侧肾上腺静脉取样期间促肾上腺皮质激素刺激的影响

本研究的目的是调查促肾上腺皮质激素 (ACTH) 刺激对原发性醛固酮增多症 (PA) 患者同时进行双侧肾上腺静脉取样 (AVS) 的意义和影响。所有诊断为 PA 的患者同时进行双侧 AVS 和 ACTH。在 95 名患者中,ACTH 后 SI 显着增加(p<0.001),并在 ACTH 刺激后从 t10-t30 逐渐下降(p<0.001)。ACTH刺激后不成功的导尿减少。ACTH 刺激后 20 分钟内的时间点更适合采样,并且选择性不会随着时间的推移而增加。根据ACTH刺激前后的偏侧化程度,可将患者分为3组(U,单侧;B,双侧):U/U、U/B或B/U、B/B。与 U/U 组相比,在 U/B 或 B/U 和 B/B 组中,基线和 ACTH 刺激后的侧化指数 (LI) 均较低 (p<0.0001),ACTH 刺激后的对侧指数 (CLI) 较高 (p< 0.003),血清钾水平较高(p<0.001),二氧化碳结合力(CO2CP)和碱过量(BE)水平较低。总之,在同时进行的双侧 AVS 中,ACTH 刺激对增加导管插入术的选择性有显着影响。刺激后观察到侧化变化。ACTH 刺激后,较少的患者可被诊断为侧化 PA。具有一致侧化 PA 的患者表现出更严重的表型。ACTH刺激后对侧指数(CLI)较高(p<0.003),血清钾水平较高(p<0.001),二氧化碳结合力(CO2CP)和碱过量(BE)水平较低。总之,在同时进行的双侧 AVS 中,ACTH 刺激对增加导管插入术的选择性有显着影响。刺激后观察到侧化变化。ACTH 刺激后,较少的患者可被诊断为侧化 PA。具有一致侧化 PA 的患者表现出更严重的表型。ACTH刺激后对侧指数(CLI)较高(p<0.003),血清钾水平较高(p<0.001),二氧化碳结合力(CO2CP)和碱过量(BE)水平较低。总之,在同时进行的双侧 AVS 中,ACTH 刺激对增加导管插入术的选择性有显着影响。刺激后观察到侧化变化。ACTH 刺激后,较少的患者可被诊断为侧化 PA。具有一致侧化 PA 的患者表现出更严重的表型。刺激后观察到侧化变化。ACTH 刺激后,较少的患者可被诊断为侧化 PA。具有一致侧化 PA 的患者表现出更严重的表型。刺激后观察到侧化变化。ACTH 刺激后,较少的患者可被诊断为侧化 PA。具有一致侧化 PA 的患者表现出更严重的表型。
更新日期:2021-06-22
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