以质量求发展，以服务铸品牌

Journal of Nursing ›› 2023, Vol. 30 ›› Issue (12): 67-69.doi: 10.16460/j.issn1008-9969.2023.12.067

Previous Articles     Next Articles

Safety of ACTH stimulation test in subtyping of primary aldosteronism patient and its nursing strategy

CAI Xiao-dan, XIA Yan   

  1. Dept. of Nursing Administration, Ruijin Hospital, Medical College, Shanghai Jiao Tong University, Shanghai 200025, China
  • Received:2022-11-01 Online:2023-06-25 Published:2023-07-10

PDF (PC)

453

Like

Abstract: Objective To explore the safety of ACTH stimulation test with 1 mg dexamethasone suppression test (DST) in subtyping of primary aldosteronism (PA) patient and its nursing strategy. Methods Forty-three patients with PA confirmed by saline infusion test underwent ACTH stimulation tests with 1 mg dexamethasone suppression test (DST). The patients fasted at 20:00 before the trial, were deprived of fluids at 22:00, took dexamethasone at 0:00 for 1 mg, and were injected 50 U of corticotropin intravenously at 8:00 on the day of the trial. Blood pressure and heart rate were measured at 0 min before injection and 5 min, 15 min, 30 min, 60 min, 90 min, 120 min after injection, and the adverse reactions were observed. Results During the test, forty-three patients had varying degree of change in blood pressure, heart rate, complexion, and discomfort complains such as dizziness, tightness chest, gastrointestinal discomfort etc. All of them completed the trial safely with immediate nursing care. Conclusion There is potential risk in ACTH stimulation test. Close observation with blood pressure, heart rate and discomfort complains of the patient are pivotal to maintaining the safety of the test as well as improving nursing quality.

Key words: primary aldosteronism, ACTH stimulation test, hypertension, nursing strategy

CLC Number: 

  • R473.5
[1] 蒋怡然,王卫庆. 中国原发性醛固酮增多症诊治专家共识解读[J]. 诊断学理论与实践,2016,15(4):350-353. DOI:10.16150/j.1671-2870.2016.04.005.
[2] Young WF, Stanson AW, Thompson GB, et al.Role for adrenal venous sampling in primary aldosteronism[J]. Surgery, 2004, 136(6):1227-1235. DOI:10.1016/j.surg.2004.06.051. PMID: 15657580.
[3] Nwariaku FE, Miller BS, Auchus R, et al.Snyder WH 3rd. Primary hyperaldosteronism: effect of adrenal vein sampling on surgical outcome[J]. Arch Surg, 2006,141(5):497-502.DOI:10.1001/archsurg.141.5.497. PMID: 16702522.
[4] 蒋怡然,王卫庆. 原发性醛固酮增多症的诊治现状及展望[J].诊断学理论与实践,2020,19(5):445-449. DOI:10.16150/j.1671-2870.2020.05.001.
[5] 王卫庆,徐媛媛,蒋怡然,等. 生理盐水试验确诊原发性醛固酮增多症临床价值再评价[J]. 中国实用内科杂志,2012,32(7):529-532.
[6] Jiang Y, Zhang C, Wang W, et al.Diagnostic value of ACTH stimulation test in determining the subtypes of primary aldosteronism[J]. J Clin Endocrinol Metab, 2015, 100(5):1837-1844. DOI: 10.1210/jc.2014-3551. Epub 2015 Feb 19. PMID: 25695882.
[7] 史佳,周莹霞. 30例原发性醛固酮增多症诊断中卡托普利试验患者的护理[J]. 护理学报,2019,26(12):67-68. DOI:10.16460/j.issn1008-9969.2019.12.067.
[8] 戴丽文,曹瑾怡,江淳弘. 原发性醛固酮增多症生理盐水试验中的风险分析及护理对策[J].护理学报,2018,25(19):56-58. DOI:10.16460/j.issn1008-9969.2018.19.056.
[9] 王琳,赵玲,朱杰,等. 生理盐水试验对原发性醛固酮增多症诊断价值的再评价[J]. 解放军医学杂志,2018,43(7):579-583. DOI:10.11855/j.issn.0577-7402.2018.07.07.
[10] 何彩英,江静,王建萍,等. 促皮质素静脉滴注治疗婴儿痉挛症副作用的临床观察[J]. 护士进修杂志,2000,15(10):745-746. DOI:10.3969/j.issn.1002-6975.2000.10.016.
[11] 《中国高血压防治指南》修订委员会. 中国高血压防治指南2018年修订版[J]. 心脑血管病防治,2019,19(1):1-44. DOI:10.3969/j.issn.1009-816X.2019.01.001.
[12] 李泉. 不同剂量快速ACTH兴奋剂试验对健康成人皮质醇分泌刺激作用的比较[D]. 太原:山西医科大学,2011. DOI:10.7666/d.y1949046.
[13] Guarini S, Cainazzo MM, Giuliani D, et al.Adrenocorticotropin reverses hemorrhagic shock in anesthetized rats through the rapid activation of a vagal anti-inflammatory pathway[J]. Cardiovasc Res, 2004,63(2):357-365. DOI: 10.1016/j.cardiores.2004.03.029. PMID: 15249194.
[14] 尹建红,张绍果. 原发性醛固酮增多症患者卧立位试验预防跌倒的护理安全管理[J]. 护理研究,2013,27(36):4161-4162. DOI:10.3969/j.issn.1009-6493.2013.36.034.
[1] LI Ke-xuan, SHEN Li-teng, LIANG Yi, XIANG Wei-xu, YING Yu-ai, LI Ling. Effect of Experiential Health Education in Patients with Hypertension [J]. Journal of Nursing, 2021, 28(3): 74-78.
[2] LU Jing-yu, YANG Lian-zhao, CHEN Ling, YANG Yong. Construction and Validation of Risk Prediction Model of Mild Cognitive Impairment in Community-dwelling Elderly Hypertensive Patients [J]. Journal of Nursing, 2021, 28(24): 42-50.
[3] LIU Dan-yang, AI Jun, LI Dan, LIAO Sheng-wu, ZHU Qing-yao, GONG Ni-rong, ZHANG Ting-ting, ZHANG Guang-qing. Effect of Regular Outpatient Follow-up on Hypertension Control and Disease Outcome in Patients Undergoing Peritoneal Dialysis: A Retrospective Cohort Study [J]. Journal of Nursing, 2021, 28(10): 11-16.
[4] JIA Ruo-ya, ZHENG Xue-mei, CHANG Yun, ZHANG Qian, YU Wan-de, JI Ting-ting, HAN Rong. Effects of Comprehensive Respiratory Function Training on Respiratory Function and Exercise Tolerance in Patients with Pulmonary Hypertension [J]. Journal of Nursing, 2019, 26(8): 46-50.
[5] MA Jie-kui,LI Qi-ci. Status and Influence Factors of Critically Ill Patients with ICU Acquired Weakness [J]. Journal of Nursing, 2018, 25(6): 45-50.
[6] DONG Ting,LIU Su-zhen,LI Ji-ping. Elderly Diabetic and Hypertension Patients ' Satisfaction with Nursing Care in Community Health Service Centers of Sichuan Province:A 2,931-case Study [J]. Journal of Nursing, 2017, 24(9): 7-10.
[7] ZHANG Xue-fang ,LU Shu-ting ,ZHANG Min ,CHEN Shao-yue ,CHEN Zhi-liang ,ZHAO Yuan-yuan . Effect of Hour Acupoint Application on Morning Peak Blood Pressure of Patients with Hyperactivity of Liver-yang [J]. Journal of Nursing, 2017, 24(8): 48-51.
[8] LIN Hang,WANG Ai-hong,WANG Xiao-xiao,DUAN Hong-wei. Status and Influence Factors of Health Locus of Control in Patients with Hypertension in Lanyuan Community of Nanjing [J]. Journal of Nursing, 2017, 24(23): 32-36.
[9] ZHANG Yong-hong,TIAN Jin-hui,ZHANG Cai-yun,ZHANG Zhi-gang,YANG Li-ping,JIN Miao-miao. Effectiveness of Group Intervention in Patients with Hypertension:A Meta-analysis [J]. Journal of Nursing, 2017, 24(15): 6-12.
[10] HAN Yong-kui,WU Sheng-nan,LIU Jing,XU Xiu-li,WANG Yue-feng. Relationship between Family Function and Self-management Behaviors in Elderly Hypertension Patients in Community [J]. Journal of Nursing, 2017, 24(11): 66-69.
[11] YANG Lin,ZUO Xiao-lin,MENG Fan-Jie,LI Qi,WANG Xin-Man. Auricular Pressure plus Western Medicine Treatment for Primary Hypertension:A Systematic Review [J]. Journal of Nursing, 2016, 23(7): 6-13.
[12] LIANG Ying-jie,LI Zhuan-zhen,FAN Shuo-ning,LI Ru-yue,JI Yi-tong,DAI Yu-qing,CAO Hui. Self-management of Elderly Hypertension Patients in Communities and Its Influence Factors [J]. , 2016, 23(6): 45-48.
[13] GU Fen,LI Yu-mei,HOU Li-li. Current Status of Anxiety of Mild Pulmonary Hypertension Inpatients and Its Influence Factors [J]. , 2016, 23(4): 18-21.
[14] GU Fen,LI Jin-ling,SUN Chun-yan,YAN Lei,HOU Li-li. SIeep QuaIity of Patients with PuImonary Hypertension and Its InfIuence Factors [J]. , 2016, 23(13): 35-37,38.
[15] WU Jing,LIU Teng-teng,SHEN Cui-zhen. Effect of Acupoint application on Excessive Accumulation of Phlegm Dampness Hypertension [J]. , 2016, 23(10): 8-11.
Viewed
Full text


Abstract

Cited
  Shared   
[1] ZHAO Xu, ZHAO Ya-ning, LI Jian-min, LIU Yao, ZHAO Da-ye, CHEN Chang-xiang. Construction of prognostic model of acute ischemic stroke in elderly individuals based on inflammatory and nutritional indicators[J]. Journal of Nursing, 2023, 30(11): 1 -6 .
[2] ZHANG Cheng-jie, JING Kun-juan, LIU Dong-xue. Efficacy comparison of nomogram and classification and regression tree in predicting stigma in elderly stroke patients[J]. Journal of Nursing, 2023, 30(11): 7 -12 .
[3] LIU Guan-lin, CHEN Jian-peng, SONG Kai-lan, Luan Yi , ZHANG Di, WANG Xin-yuan, ZHOU Ting, KONG Ying. Effect of three-level linkage combined with family empowerment model on control of sudden symptoms in patients with hospice care at home[J]. Journal of Nursing, 2023, 30(11): 13 -16 .
[4] GONG Shu-ping, WANG Xiao-min, JIANG Yu-xiao, SUN Xiao-ying, ZHAO Xiao-min. Latent profile and influencing factors of empathy of nursing students at early stage of internship[J]. Journal of Nursing, 2023, 30(11): 17 -21 .
[5] . [J]. Journal of Nursing, 2023, 30(11): 22 -26 .
[6] . [J]. Journal of Nursing, 2023, 30(11): 27 -30 .
[7] . [J]. Journal of Nursing, 2023, 30(11): 31 -35 .
[8] . [J]. Journal of Nursing, 2023, 30(11): 36 -40 .
[9] TU Ying, DU Dan-yang, SHU Yan, ZENG Tao. Best evidence summary of prevention of recurrent ischemic stroke[J]. Journal of Nursing, 2023, 30(11): 41 -46 .
[10] . [J]. Journal of Nursing, 2023, 30(11): 47 -52 .