血浆肾素活性在肾上腺占位病变功能评估中的作用

Value of PRA in assessing functional adrenal mass

关键词:  原发性醛固酮增多症  库欣综合征  嗜铬细胞瘤  神经节细胞瘤  肾素活性

Key words:  primary aldosteronism  cushing’s syndrome  phaeochroncocytomas  ganglioneuroma  plasma renin activity

摘要:

目的　探讨血浆肾素活性在肾上腺占位病变功能评估中的作用。方法　选取解放军总医院2012年5月至2015年4月因肾上腺占位于内分泌科住院后又于泌尿外科行手术治疗的患者329例，其中无功能瘤67例，嗜铬细胞瘤53例，库欣综合征55例，原发性醛固酮增多症136例，神经节细胞瘤18例，比较不同病因患者术前立位肾素水平。结果　嗜铬细胞瘤、神经节细胞瘤的肾素水平明显高于无功能瘤、库欣综合征及原发性醛固酮增多症患者(P＜0.01)，原发性醛固酮增多症肾素水平最低(P＜0.01)，嗜铬细胞瘤和神经节细胞瘤患者之间的肾素水平,库欣综合征与无功能瘤患者之间的肾素水平无统计学差异（P＞0.05）。结论　原发性醛固酮增多症的患者立位肾素活性明显受抑，嗜铬细胞瘤和神经节细胞瘤的立位肾素活性明显升高，而库欣综合征的患者肾素活性与无功能瘤患者无明显差异，因此立位肾素活性在诊断原发性醛固酮增多症、嗜铬细胞瘤及神经节细胞瘤中有一定的临床意义。

Abstract:

Objective　 To investigate the value of plasma renin activity (PRA) level in assessing different functional adrenal masses. 　Methods　 Totally 329 patients, who underwent adrenal mass resection, were enrolled including 67 cases of nonfunctional adenoma, 53 cases of phaeochroncocytomas, 55 cases of Cushing’s syndrome, 136 cases of primary aldosteronism, and 18 cases of ganglioneuroma. All patients were admitted into Chinese PLA General Hospital between May 2012 and April 2015. PRA levels of different functional adrenal masses were compared. 　Results　 The PRA levels in patients with phaeochroncocytomas and ganglioneuroma were significantly higher than those in the other groups (P＜0.01). The PRA level in patients with primary aldosteronism was the lowest (P＜0.01). There were no significance differences in PRA levels among patients with phaeochroncocytomas, ganglioneuroma, Cushing’s syndrome, and nonfunctional adenoma (P＞0.05）. 　Conclusion　 PRA level is significantly suppressed in patients with primary aldosteronism, but rise in phaeochroncocytomas and ganglioneuroma. Therefore, PRA measurement has clinical implication in distinguishing among primary aldosteronism, phaeochroncocytomas and ganglioneuroma.