肾上腺髓样脂肪瘤合并高血压的临床特点分析

Clinical analysis of adrenal myelolipoma complicated with hypertension

目的探讨肾上腺髓样脂肪瘤(AML)合并高血压的临床特点及术后高血压缓解的影响因素。方法选取2008年9月~2017年8月于四川大学华西医院确诊并接受手术治疗的肾上腺髓样脂肪瘤合并高血压患者52例,根据术后血压缓解情况分为缓解组(12例)和未缓解组(40例)。比较两组围手术期血压、术前高血压持续时间、高血压家族史、术前血浆肾上腺素、术前血浆去甲肾上腺素、肿瘤直径、肿瘤位置、肿瘤重量、伴随症状,分析术后高血压缓解的影响因素,结合肾上腺CT表现,分析术后高血压缓解的可能机制。结果缓解组肿瘤位置(右侧11例,左侧1例)与未缓解组(右侧20例,左侧20例)比较,差异有统计学意义(P<0.05);缓解组的术前高血压持续时间比未缓解组短,差异有统计学意义(P<0.05);两组患者在术前血浆肾上腺素、术前血浆去甲肾上腺素、围手术期血压、高血压家族史、肿瘤直径及重量、伴随症状方面差异均无显著统计学意义(P>0.05)。结论肾上腺髓样脂肪瘤术后高血压缓解的影响因素为肿瘤位置和术前高血压持续时间。术前高血压持续时间过长可能导致血管不可逆损害,不利于术后高血压缓解。

Objective To observe the clinical features of adrenal myelolipoma with hypertension and analyze the influencing factors of postoperative hypertension relief.Methods 52 patients with adrenal myelolipoma and hypertension diagnosed and treated in our hospital were divided into remission group ( n =12 ) and non-remission group ( n =40 ) according to postoperative blood pressure relief.Perioperative blood pressure,duration of preoperative hypertension,family history of hypertension,preoperative plasma adrenaline,preoperative plasma norepinephrine,tumor diameter,tumor location,tumor weight,and accompanying symptoms differences were compared between the two groups.Results The difference of tumor location of the two groups was significant ( P <0.05).The duration of preoperative hypertension in the remission group was shorter than that that in the non-remission group ( P <0.05).Conclusion The influencing factors of postoperative hypertension remission in adrenal myelolipoma are tumor location and duration of preoperative hypertension.Excessive duration of preoperative hypertension may cause irreversible damage to blood vessels,which is not conducive to the relief of postoperative hypertension.