高血压伴肾上腺增生临床分析

Clinical analysis of patients with hypertension complicated adrenal hyperplasia

目的:探讨高血压伴肾上腺增生患者的临床特点。方法:对685例高血压患者进行肾上腺CT检查,以CT显示有肾上腺增生的高血压患者为观察组,共有114例,同时随机选取141例CT显示肾上腺正常的高血压患者为对照组,对两组患者的临床指标进行对比分析。结果:(1)在685例高血压患者中,伴肾上腺增生的有114例,占受检人群的16.64%。99例伴左侧肾上腺增生(86.84%),1例伴右侧肾上腺增生(0.88%),14例伴双侧肾上腺增生(12.28%);(2)观察组17点皮质醇水平明显高于对照组[(8.22±4.39)μg/dl∶(7.06±3.01)μg/dl,P<0.05];(3)观察组血钾水平显著低于对照组[(3.74±0.36)mmol/L∶(3.88±0.37)mmol/L,P<0.05];(4)相关分析显示观察组+对照组、对照组的血钾均与服糖2h血糖呈负相关(r=-0.235,-0.293,P均<0.05);观察组血糖与血钾无相关性。结论:高血压伴肾上腺增生患者中肾上腺增生大部分为左侧肾上腺增生,其增生的肾上腺可能有自主分泌功能,影响血压的调节及血钾水平,高血压患者血钾与血糖呈负相关,高血压伴肾上腺增生患者血钾与血糖无相关性。

Objective：To explore the clinical features of patients with hypertension complicated adrenal hyperplasia.Methods：A total of 685 patients with hypertension received CT examination on adrenal glands.According to the results of CT,patients with hypertension complicated adrenal hyperplasia were enrolled as observation group（n=114）,and another 141 hypertensive patients without adrenal hyperplasia were randomly selected as control group.Clinical indexes of the two groups were compared and analyzed.Results：（l） Among 685 patients with hypertension,there were 114 cases of adrenal hyperplasia（16.64%）,including 99 cases of left adrenal hyperplasia（86.84%）,one case of right adrenal hyperplasia（0.88%） and 14 cases of adrenal hyperplasia on both sides（12.28%）;（2） Level of cortisol at 17 o＇clock in observation group was significantly higher than that of control group [（8.22±4.39） μg/dl vs.（7.06±3.01） μg/dl,P0.05];（3） Serum level of potassium in observation group was significantly lower than that of control group [（3.74±0.36） mmol/L vs.（3.88±0.37） mmol/L,P0.05];（4） Correlation analysis indicated that serum potassium was negatively correlated with blood glucose two hours after taking sugar in observation group ＋ control group and control group（r=-0.235,-0.293,P0.05 both）,and there was no correlation between blood glucose and serum potassium in observation group.Conclusion： Most of patients with hypertension complicated adrenal hyperplasia are of left adrenal hyperplasia,the hyperplastic adrenal gland may have independent function of secretion and impact on regulation of blood pressure and level of serum potassium.Serum potassium is negatively correlated with blood glucose in patients with hypertension.There is no correlation between serum potassium and blood glucose in patients with hypertension complicated adrenal hyperplasia.