Adrenocorticotrophic hormone stimulation in adrenal vein sampling
10.3760/cma.j.cn311282-20220413-00225
- VernacularTitle:促肾上腺皮质激素刺激在肾上腺静脉采血中的应用价值评估
- Author:
Yijie WANG
1
;
Yangjie ZENG
;
Mengsi LIU
;
Huan CHEN
;
Yuan LOU
;
Zhaoyang TIAN
;
Ziwei ZHANG
;
Ping LI
Author Information
1. 南京医科大学鼓楼临床医学院，南京大学医学院附属鼓楼医院内分泌科 210008
- Keywords:
Primary aldosteronism;
Adrenal vein sampling;
Adrenocorticotrophic hormone;
Selectivity index;
Lateralization index
- From:
Chinese Journal of Endocrinology and Metabolism
2022;38(11):957-962
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of adrenocorticotrophic hormone (ACTH) stimulation in adrenal vein sampling (AVS) with its effect on the sampling success rate and lateralization determination.Methods:The clinical data of 54 patients with primary aldosteronism (PA) who underwent AVS in Nanjing Drum Tower Hospital from July 2018 to June 2020 were collected retrospectively. Blood samples from bilateral adrenal veins were collected simultaneously at baseline and after ACTH stimulation. The selectivity index (SI), lateralization index (LI), and relative aldosterone secretion index (RASI) were examined.Results:The concentration of serum cortisol level in left and right adrenal vein and peripheral vein increased significantly after ACTH stimulation ( P<0.001). SI of left adrenal vein increased from 18.00 (2.29, 20.29) to 34.76 (12.10, 46.86) , and the SI of right adrenal vein increased from 26.61(5.24, 31.85) to 28.40 (27.65, 56.05, P<0.001). The bilateral vein sampling success rate increased from 80%(43/54) to 93%(50/54). LI decreased from 2.85(1.78, 6.20) at baseline to 2.45(1.40, 6.10) after ACTH stimulation without significant difference( P>0.05). Eleven patients who identified unilateral secretion at baseline demonstrated bilateral after ACTH stimulation, and the RASI of these patients decreased from 0.50 (0.38, 1.25 ) to 0.37 (0.22, 0.84, P=0.019). Conclusion:ACTH stimulation significantly increased SI and the AVS success rate in patients with PA: ACTH stimulation decreased the relative aldosterone secretion in the dominant side of some patients with aldosterone producing adenoma, thus reduced the proportion of identified unilateral PA.
