Comparison of Bolus and Continuous Infusion of Adrenocorticotropic Hormone During Adrenal Vein Sampling.
Comparison of Bolus and Continuous Infusion of Adrenocorticotropic Hormone During Adrenal Vein Sampling.
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肾上腺静脉采样期间推注和连续输注促肾上腺皮质激素的比较
DOI：
10.3389/fendo.2021.784706
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发表时间：
2021
影响因子：
5.2
通讯作者：
Yang S
中科院分区：
文献类型：
--
作者：
Hu J;Chen J;Cheng Q;Jing Y;Yang J;Du Z;Song Y;Ma L;Yang Y;Luo T;Wang Y;Li Q;Yang S
促肾上腺皮质激素（ACTH）被广泛用于肾上腺静脉采样（AVS），并可作为推注或连续输注给药。尚未确定最佳给药方法。我们的目的是比较促肾上腺皮质激素推注与输注对插管成功率、偏侧评估和不良事件（AE）的影响。Retrospective收集了在中国一家三级医院接受AVS联合ACTH治疗的原发性醛固酮增多症患者的数据。分析插管成功率、偏侧指数（LI）、完全生化缓解和与AVS相关的AE。该研究包括80名接受ACTH推注的患者和94名接受输注的患者。推注组和输注组的插管成功率相当（75/80，93.4% vs 88/94，93.6%）。在成功插管的患者中，推注组的选择性指数高于输注组，而LI [6.4（1.8-17.5）vs. 7.6（2.0-27.8），P=0.48]和完全生化缓解率（43/44，97.7% vs. 53/53，100%，P=0.45）在两组之间无显著差异。推注组和输注组各有1例患者发生肾上腺静脉破裂，但经保守治疗后痊愈。推注组报告的一过性AE（如心悸（52.9% vs 2.2%）和腹部不适（40.0% vs 2.2%））多于输注组。由于其对插管成功和偏侧化的作用相似，但输注组中一过性AE的发生率较低，因此应推荐连续输注方法用于AVS的ACTH刺激。
Adrenocorticotropic hormone (ACTH) is widely used in adrenal vein sampling (AVS) and can be administered as a bolus injection or continuous infusion. The optimal administration method has not been determined. We aimed to compare the effects of ACTH bolus with infusion on cannulation success, lateralization assessment and adverse events (AEs). Retrospectively collected data from patients with primary aldosteronism who underwent AVS with ACTH at a tertiary hospital in China. Rate of successful cannulation, lateralization index (LI), complete biochemical remission and AEs related to AVS were analyzed. The study included 80 patients receiving ACTH bolus and 94 receiving infusions. The rate of successful cannulation was comparable between bolus and infusion groups (75/80, 93.4% vs 88/94, 93.6%). In those with successful cannulation, the bolus group had a higher selectivity index than the infusion group, while LI [6.4(1.8-17.5) vs. 7.6(2.0-27.8), P=0.48] and rate of complete biochemical remission (43/44, 97.7% vs 53/53, 100%, P=0.45) did not significantly differ between the two groups. One in the bolus and one patient in the infusion group had adrenal vein rupture but they recovered with conservative treatment. The bolus group reported more transient AEs such as palpitation (52.9% vs 2.2%) and abdominal discomfort (40.0% vs 2.2%) than the infusion group. Due to their similar effects on cannulation success and lateralization, but a lower rate of transient AEs in the infusion group, the continuous infusion method should be recommended for ACTH stimulation in AVS.
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影响因子：
44.5
作者：
Dekkers, Tanja;Prejbisz, Aleksander;Deinum, Jaap
通讯作者：
Deinum, Jaap
影响因子：
2.6
作者：
Young, William F., Jr.;Du Plessis, Hendrick;Carpenter, Paul C.
通讯作者：
Carpenter, Paul C.
DOI：
10.3109/10641968309081788
发表时间：
1983-01-01
期刊：
CLINICAL AND EXPERIMENTAL HYPERTENSION PART A-THEORY AND PRACTICE
影响因子：
--
作者：
WHITWORTH, JA;SAINES, D;SCOGGINS, BA
通讯作者：
SCOGGINS, BA
影响因子：
--
作者：
WOOD, CE;CHEN, HG
通讯作者：
CHEN, HG
影响因子：
5.8
作者：
Funder, John W.;Carey, Robert M.;Young, William F., Jr.
通讯作者：
Young, William F., Jr.