临床前期原发性醛固酮增多症

Preclinical primary aldosteronism

目的 为了提高肾上腺偶发瘤的诊治效果 ,提出临床前原发性醛固酮增多症的概念。方法 采取回顾性研究的方法对无症状的肾上腺皮质球状带肿瘤进行分析总结。结果 B超、CT检查偶然发现肾上腺肿瘤 9例 ,其中血压正常高值 2例 ,血钾正常低值 5例 ,血醛固酮正常高值 5例 ,稍高于正常 4例 ,血浆肾素活性为正常低值 ,立位醛固酮检测 2例稍低于卧位 ,2例小剂量地塞米松抑制试验被抑制。结论 临床前原发性醛固酮增多症 ,有自主分泌激素或潜在分泌激素的肿瘤 ,且直径≥ 2 .0cm ,随访中有增大趋势者 。

Objective To improve the diagnostic and theraputic potency for incidentally discovered adrenal tumor.Methods Asymptomatic adrenal tumor in glomerular zone of adrenal cortex have been reviewed retrospectively.Results 9 cases of adrenal tumor were discovered incidentally by B ultrasonography and CT scanning.Blood pressure in 2 of these cases was nearly the same as the upper limit of reference value,5 cases demonstrated serum potassium level near the lower limit of reference value,4 cases demonstrated higher plasma aldosterone levels than normal while there were still 5 cases at the upper limit of reference value.Plasma renin activities were normal in all these cases.Plasma aldosterone response in position test was positive in 2 of these cases and suppression of serum cortisone was detected with low dose dexamethasone suppression test.Conclusion Adrenalectomy should be undertaken in those preclinical primary aldosteronism with autonomous or potential hormone secretions,lager than 2 cm in diameter and those with trend of increasing in tumor size.