肾上腺意外瘤中醛固酮瘤患者的临床和生化特征

Clinical and Biochemical Features of Patients with Aldosteronoma in Adrenal Incidentaloma

目的分析肾上腺意外瘤中醛固酮瘤患者的临床及生化特征。方法9例肾上腺意外瘤中醛固酮瘤患者(A组)和15例有症状的醛固酮瘤患者(B组),分别进行血尿电解质、血尿醛固酮、血浆肾素活性及肾上腺CT检查,对两组患者的临床特征和生化检测结果进行比较分析。结果两组肿瘤直径和血压比较无统计学差异;A组患者年龄、血醛固酮、血醛固酮与血浆肾素活性比值均明显高于B组(P<0.05);B组低血钾者占46.7%,而A组患者血钾均在正常范围(P<0.05)。结论肾上腺意外瘤中有部分患者为醛固酮瘤,其醛固酮分泌轻度升高可导致高血压的发生;需进行内分泌功能检查以明确性质,并及时进行手术治疗。

Objective To evaluate the clinical and biochemical features of patients with aldosteronoma in adrenal incidentaloma. Methods Nine patients with aldosteronoma in adrenal incidentaloma （group A） were evaluated, all of whom underwent examinations of plasma and urinary potassium, plasma and urinary aldosterone, plasma renin activity and abdominal CT scan. These data were compared with those of 15 sympatomatic aldosteronoma （group B）. Results The patients of group A were older than group B. There was no significant difference in diameter of tumors and blood pressure between the two groups. All patients of group A had normal serum potassium, but patients with hypokalemia accounted for 46.7% in group B （P 〈0.05）. There was significant difference in the values of serum aldosterone, plasma aldosterone and plasma rennin activity ratio between the two groups （P 〈 0.05）. Conclusion Aldosteronoma can be found in part of the patients with adrenal incidentaloma. Even if the aldosterone excess is minor, it may induce hypertension. Patients with aldosteronoma in adrenal incidentaloma shall be searched out for timely treatment.