测量的进展能够更准确地评估高血压患者的醛固酮产生。然而,新试验的截止值尚未得到充分验证.本研究旨在验证醛固酮的新型化学发光酶免疫测定法以及其他方法。此外,我们还旨在使用新的检测方法在卡托普利激发试验中建立原发性醛固酮增多症的新临界值。首先,我们收集了390份血浆样本,其中使用液相色谱-质谱法测量的醛固酮水平在0.18和1346ng/dL之间。新的化学发光酶免疫分析显示血浆醛固酮与液相色谱-质谱,与常规放射免疫测定相反。Further,我们纳入了299和39例原发性醛固酮增多症和原发性高血压患者,分别。使用新测定法测得的血浆醛固酮浓度低于放射免疫测定法测得的浓度。这导致醛固酮与肾素的比率降低。随后,基于放射免疫测定的卡托普利挑战试验的阳性结果变成了“阴性”,基于45%原发性醛固酮增多症患者的新测定,使用常规临界值(醛固酮与肾素活性比>20ng/dL/ng/mL/h)。受试者工作特征曲线分析表明,新测定中醛固酮与肾素的活性比>8.2ng/dL/ng/mL/h与常规诊断兼容(灵敏度,0.874;特异性,0.980)。我们的研究表明,醛固酮的新型化学发光酶免疫测定具有很高的测量精度,以及测量校正的截止值在原发性醛固酮增多症诊断中的重要性。
The measurement evolution enabled more accurate evaluation of aldosterone production in hypertensive patients. However, the cut-off values for novel assays have been not sufficiently validated. The present study was undertaken to validate the novel chemiluminescent enzyme immunoassay for aldosterone in conjunction with other methods. Moreover, we also aimed to establish a new cut-off value for primary aldosteronism in the captopril challenge test using the novel assay. First, we collected 390 plasma samples, in which aldosterone levels measured using liquid chromatography-mass spectrometry ranged between 0.18 and 1346 ng/dL. The novel chemiluminescent enzyme immunoassay showed identical correlation of plasma aldosterone with liquid chromatography-mass spectrometry, in contrast to conventional
radioimmunoassay. Further, we enrolled 299 and 39 patients with primary aldosteronism and essential hypertension, respectively. Plasma aldosterone concentrations measured using the novel assay were lower than those measured by
radioimmunoassay, which resulted in decreased aldosterone-to-renin ratios. Subsequently, positive results of the captopril challenge test based on
radioimmunoassay turned into \"negative\" based on the novel assay in 45% patients with primary aldosteronism, using the conventional cut-off value (aldosterone-to-renin activity ratio > 20 ng/dL per ng/mL/h). Receiver operating characteristic curve analysis demonstrated that aldosterone-to-renin activity ratios > 8.2 ng/dL per ng/mL/h in the novel assay was compatible with the conventional diagnosis (sensitivity, 0.874; specificity, 0.980). Our study indicates the great measurement accuracy of the novel chemiluminescent enzyme immunoassay for aldosterone, and the importance of measurement-adjusted cut-offs in the diagnosis of primary aldosteronism.