摘要
探讨原发性醛固酮增多症(原醛)临床特点及诊治方面的经验,以早期诊断、根治,改善预后。对确诊的原醛53例临床资料(临床特征、实验室检查、影像学检查、病理类型、治疗情况)进行回顾性研究。男女比为1:1.65,30~49岁年龄段最多。50.9%高血压首发,15.1%低钾血症首发,并发高心痛9.4%,尿毒症1.9%,脑卒中13.2%。肾素-血管紧张素-醛固酮(RAA)系统激素检查,血浆醛固酮/血浆肾素活性比值(ARR)>200者80.7%,ARR>400者占半数,血浆醛固酮(PAC)>140pg/ml者占84.6%。CT及MRI阳性率高。术后病理肾上腺皮质腺瘤占85%,结节性增生占15%(其中原发性肾上腺增生占12.5%)。手术后血压及血钾均较前改善,非手术者口服安体舒通有效。原醛是可治性内分泌性高血压之一,建议高血压和/或低血钾者应常规检查RAA系统激素,并争取行影像学检查,以使原醛得到早期诊治,改善预后。
To discuss and summarize the experience of its clinical characteristic, diagnosis and treatment, in order to diagnose, treat as early as possible and improve the prognosis of primary aldosteronism(PA). Analyzed the clinical data(clinical characteristic,data of laboratory, image,pathogic type)of 53 patients with PA in our hospital during the period of 1996- 2003. The proportion of the cases male and female was 1 : 1.65, it happens in the period of 30 - 49 years old most easily. Of 50.9% cases, hypertention wsa diagnosed first. Of 15.1% cases, hypokalaemia first. Among these cases ,9.4 % cases were also with hypertension heart disease, 1. 9% of them were with uriontoxaemia. 13.2% of them suffered from cerebrovascular disease. ARR(200 was 80.7%, 51.9% of the cases ARR(400, PAC( 140pg/ml was 84.6%. The highest positive rate of diagnosis were CT and MRI. According to the pathologic type after opration ,adrenal adenoma was 85%, nodular hyperplasia was 15% ,primary adrenal hyperplasia was 12. 5 %. hypertention and hypokalaernia were improved after operation. Without operation , the level of blood potassium of the cases with oral aldasterone were aslo satisfied. Primary aldasteronism is one of the reasons of treatable endocrine hypertension, we suggest the patients with hypertension and/or hypopotassium should examine their RAA system, and try their best to get the image data in order to diagnose and treat this disease and improveits progonosis.
出处
《医学与哲学(B)》
2006年第5期44-46,共3页
Medicine & Philosophy(B)