standing test

The standing test was carried out by the following principle. Normal people stayed in bed overnight. The plasma aldosterone value was about 110-330 pmol/L at 8 am, and the plasma aldosterone concentration decreased and the plasma cortisol concentration decreased from 12 to 12 noon. The decline is consistent; when taking the standing position, plasma aldosterone rises because the effect of elevated renin-angiotensin after standing exceeds the effect of ACTH. In patients with aldosteronism, plasma aldosterone rises at 8:00 to 12:00, and exceeds normal, due to a slight increase in plasma renin after standing, and the sensitivity of this type to angiotensin is enhanced; aldosterone Under these conditions, plasma aldosterone does not rise, but decreases, because the patient's renin-angiotensin system is more severely inhibited and cannot rise after standing. Renin-reactive adenoma, blood aldosterone is significantly elevated due to changes in plasma renin caused by standing position. Basic Information Specialist classification: urinary examination classification: blood examination Applicable gender: whether men and women apply fasting: not fasting Tips: Pay attention to the normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Normal value Normal people stayed in bed overnight, and the plasma aldosterone value was about 110-330 pmol/L at 8 am. The plasma aldosterone concentration decreased from the recumbent position to 12 noon, which was consistent with the decrease in plasma cortisol concentration. Clinical significance Abnormal results: (1) Aldosterone tumors are more common, mostly adenomas on one side, most of which are between 1 and 2 cm in diameter. The patient's plasma aldosterone concentration is parallel to the circadian rhythm of plasma ACTH, but to plasma. There was no significant response to changes in renin. (B) renin-reactive adenoma a small number of adenoma patients with increased renin increased aldosterone. (3) Idiopathic aldosteronism (referred to as special aldosteronism) is also common. Bilateral adrenal spheroidal hyperplasia, sometimes with nodules. The cause may be related to increased sensitivity to angiotensin II, which reduces aldosterone secretion, hypertension, and hypokalemia. A small number of patients with bilateral adrenal nodular hyperplasia, no response to excitatory renin-angiotensin system tests (such as straight steric position, sodium intake, intravenous diuretics, etc.) and inhibition tests (such as high sodium load) It is called primary aldosteronism caused by primary adrenal hyperplasia. People who need to be examined: Suspected patients with aldosteronoma, renin-responsive adenoma, and special aldosteronism. Precautions Forbidden before examination: pay attention to normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Requirements for inspection: Actively cooperate with the doctor's request. Inspection process method: Resting overnight, taking blood samples for renin, angiotensin, and aldosterone in the morning. Keep standing for 4 hours, and take blood to measure renin, angiotensin and aldosterone. The result is judged: In patients with adrenal cortical aldosterone-secreting adenoma, the level of aldosterone was significantly higher than normal, and the level of renin-angiotensin was significantly lower than normal. After 4 hours of standing, aldosterone was lower than before, and renin-angiotensin was unchanged. . Renin-reactive adenoma, renin, angiotensin, aldosterone increased in the standing position. Result analysis: If the patient's basal blood aldosterone level is significantly elevated, renin-angiotensin is inhibited, blood aldosterone decreases after 4 hours of standing, consistent with ACTH rhythm, renin-angiotensin is still inhibited, suggesting an abnormal increase in aldosterone secretion, combined Adrenal CT results support the diagnosis of adrenal cortical aldosterone secreting adenoma. Not suitable for the crowd Inappropriate crowd: temporarily unknown. Adverse reactions and risks No related complications or hazards.