Clinical application of adrenal vein sampling in patients with primary aldoste-ronism
Objective Explore the clinical significance of adrenal vein sampling(AVS)in the decision-making and efficacy evaluation of therapy strategy for patients with primary hyperaldosteronism(PA).Methods A retro-spective analysis was conducted on clinical data from 77 patients with primary aldosteronism who were admitted to the urology department of the affiliated hospital of Zunyi medical university from January 2020 to December 2023.Based on different preoperative examination methods,they were divided into the CT examination group(Group A,40 cases)and the CT plus adrenal venous sampling group(Group B,37 cases).Preoperative and postoperative blood potassium,cortisol,aldosterone,blood pressure,hospitalization expenses,and other related data between the two groups were compared.Results The average hospitalization cost for group B was found to be significantly higher than that for group A(P＜0.01).CT results of the adrenal glands in group A showed that predominantly unilateral lesions were present,while group B predominantly had bilateral lesions and the tumor volume of unilateral lesions in group A was observed to be larger than that in group B and the tumor volume on the surgical side of bilateral lesions in group A was found to be larger than that in group B(P＜0.01).Postop-erative peripheral blood cortisol and aldosterone levels were lower than preoperative levels in both group A and group B,both groups were observed to have lower postoperative systolic and diastolic pressures compared to pre-operative values(P＜0.05).Conclusion The impact of preoperative AVS on surgical efficacy of adrenal gland is not shown to have significant differences;both can effectively control blood pressure.However,the decision of adrenal gland resection side in patients with primary aldosteronism can be guided by AVS,especially providing a surgical basis for patients with unilateral adenoma and bilateral adrenal lesions.
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