Clinical application of AVS in the precision treatment of hypertension caused by primary aldosteronism
Objective:This article is to investigate the clinical value of adrenal venous sampling(AVS)in the precise localization treatment of hypertension caused by primary aldosteronism.Methods:A retrospective analysis of patients with adrenal tumors complicated with hypertension who were admitted to The Second Affiliated Hospital of Shandong First Medical University&Shandong Academy of Medical Science from September 2022 to December 2023.Enrolled cases were determined by inclusion and exclusion criteria.Preoperative and postoperative clinical and biochemical indicators of twenty-five enrolled cases were collected and the surgical treatment effect of patients by comparing the changes in preoperative and postoperative clinical and biochemical indicators was evaluated the clinical value of AVS in guiding the precise surgical treatment of primary aldosteronism.Results:The types of antihypertensive drugs used in the twenty-five patients were significantly reduced compared with those before operation,and the blood pressure was significantly improved compared with those before operation,and the difference was statistically significant(P<0.001).The serum potassium level of the postoperative patient was improved compared with that before the operation,and the difference was statistically significant(P=0.004).However,due to the secretion characteristics of aldosterone hormone in peripheral blood,which include diurnal variation and episodic fluctuations.A single measurement of peripheral venous aldosterone levels may not be sensitive.In some patients,the peripheral blood aldosterone concentration is within the normal range.However,by AVS,we found that these patients all had hyperfunctional secretion of unilateral adenomas.After surgical removal of the high functional lateral adenomas,then,we compared the preoperative and postoperative plasma aldosterone concentrations,and the difference was statistically significant(P<0.001).However,due to the characteristic of the secretion of aldosterone hormone,relying solely on plasma aldosterone concentration cannot determine whether adrenal adenoma have secretion function or not.Conclusion:Evaluating the surgical treatment effect of patients by comparing the changes in preoperative and postoperative clinical and biochemical indicators,all patients showed varying degrees of improvement in clinical and biochemical indicators during the six-month follow-up after surgery.Therefore,AVS technology can accurately guide the surgical side,improve the clinical and biochemical cure rate of patients,reduce unnecessary surgical treatments,improve surgical outcomes,and enhance the quality of life of patients.
万方数据
维普
