Objective: To re-evaluate the diagnostic efficacy of the Chongqing Primary Aldosteronism Study (CONPASS) model for unilateral primary aldosteronism (UPA). Methods: This retrospective study included patients with primary aldosteronism (PA) who underwent subtyping via adrenal venous sampling, postoperative outcomes, or both, between April 2022 and June 2025 at the First Affiliated Hospital of Chongqing Medical University. The accuracy of the CONPASS model (comprising serum potassium ≤3.5 mmol/L, plasma aldosterone concentration ≥200 pg/ml, plasma renin concentration ≤5 mU/L, and a unilateral adrenal nodule ≥10 mm on CT) was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, and the corresponding 95% confidence intervals (CI). The diagnostic efficacy of the CONPASS model was subsequently compared with that achieved using the Endocrine Society clinical practice guidelines-recommended approach (comprising typical clinical features, age <35 years, and a unilateral adrenal nodule >1 cm on CT). Results: A total of 267 patients with a definitive subtyping diagnosis (151 with UPA and 116 with bilateral PA) were enrolled. The cohort comprised 145 females (54.3%), aged 25 to 76 years, with a median age of 51 years. The CONPASS model demonstrated a sensitivity of 31.8% (48/151) (95%CI 24.5%-39.9%) and a specificity of 98.3% (114/116) (95%CI 93.9%-99.8%). The predictive value was 96.0% (48/50) (95%CI 86.3%-99.5%), and negative predictive value was 52.5% (114/217) (95%CI 45.7%-59.3%). In comparison, application of the guideline-recommended criteria achieved a specificity of 100.0% (116/116) (95%CI 96.9%-100.0%) but a sensitivity of only 2.0% (3/151) (95%CI 0.4%-5.7%). This represents a significantly lower identification rate for UPA relative to the CONPASS model. Among the UPA patients correctly identified by the CONPASS model, 93.8% (45/48) were ≥35. Conclusions: This study further validates the high diagnostic accuracy of the CONPASS model. Eliminating the age restriction present in current guideline criteria permits the identification of a larger proportion of UPA patients who are candidates for surgical intervention. 目的： 再次验证重庆原发性醛固酮增多症队列（CONPASS）模型对单侧原发性醛固酮增多症（UPA）的诊断效能。 方法： 回顾性纳入2022年4月至2025年6月在重庆医科大学附属第一医院经肾上腺静脉取血和/或术后结局明确分型的原发性醛固酮增多症（PA）患者，通过敏感度、特异度、阳性预测值、阴性预测值及其95%置信区间（CI）评估CONPASS模型（血钾≤3.5 mmol/L、血浆醛固酮浓度≥200 pg/ml、肾素浓度≤5 mU/L和CT示单侧肾上腺结节且直径≥10 mm）的准确性，并与美国内分泌学会指南推荐标准（典型PA临床特征、年龄小于35岁且CT示>1 cm的单侧肾上腺结节）进行比较。 结果： 共纳入267例明确分型的PA患者（UPA 151例，双侧PA 116例），其中女性145例（54.3%），年龄25~76岁，中位年龄51岁。CONPASS模型诊断UPA的敏感度为31.8%（48/151）（95%CI 24.5%~39.9%），特异度为98.3%（114/116）（95%CI 93.9%~99.8%），阳性预测值为96.0%（48/50）（95%CI 86.3%~99.5%），阴性预测值为52.5%（114/217）（95%CI 45.7%~59.3%）；而指南推荐标准虽然特异度达100.0%（116/116）（95%CI 96.9%~100.0%），但识别UPA的比例远低于CONPASS模型，敏感度仅为2.0%（3/151）（95%CI 0.4%~5.7%）。在模型正确识别的UPA患者中，93.8%（45/48）年龄≥35岁。 结论： 本研究再次验证CONPASS模型有较高的准确性，取消年龄限制有助于识别更多可能手术获益的UPA患者。.
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