血浆醛固酮与肾素活性比值测定方法标准化问题的探讨

血浆醛同酮与血浆肾素活性比值(ARR)已广泛应用在高血压患者中筛查原发性醛同酮增多症(原醛).研究表明,不同的临床状况(测定方法)会得出不同的ARR.由于没有统一的ARR标准,使得其临床应用难以适从.因此,应该根据所选用的测定方法和本单位的试验条件,采用相应的,同时具最高敏感性、特异件和准确件的ARR.近年来通过控制测定条件,即所谓测定方法标准化,包括:停用降压药2～4周、取同定体位、上午8:00～12:00之间采血、充分钠摄入以及低血钾者补钾等,发现原醛的ARR范围大致在23.6～26.0 ng·dl-1·ng-1·ml-1·h-1之间,说明ARR筛查方法标准化有助于确定和统一筛查原醛的ARR标准.

Discussion on the standardization of the assay methods of plasma aldosterone to plasma renin activity ratio in the screening of primary aldosteronism

Plasma aldusterone to plasma renin activity ratio(ARR) has been widely used for the screening of primary aldosteronism(PA) in patients with hypertension.Researches show that different criteria of ARR could be, yielded under different assay methods.It is difficult to determine which value of ARR should be adopted in clinical practice due to no unified criteria of ARR.Therefore, corresponding ARR for diagnosis of PA, which should be simuhaneously with the must highest level of sensitivity, accuracy and specificity,should be selected according to the assay method adopted and test conditions in the local laboratory. Rewhich includes stop use of antihypertensive drugs for 2-4 weeks before tests, taking fixed body postures,sampling for plasma between 8: 00-12: 00, sufficient intaking of natrium and supplying of potassium for patients with hypokalemia.Studies show that the standardization of assay method for ARR conduces to confirmation and unification of the ARR criteria for screening PA.