经皮选择性肾上腺动脉栓塞治疗原发性醛固酮增多症——现状与展望

Superselective Adrenal Arterial Embolization for Primary Aldosteronism:Current Status and Future Perspectives

原发性醛固酮增多症(PA)是继发性高血压常见的原因之一,对靶器官损害往往比原发性高血压更为严重,预后更差。因此,对该病作出早期诊断和针对性治疗至关重要。研究已发现降低该病患者血浆醛固酮水平比拮抗醛固酮受体的治疗策略更符合病理生理逻辑,临床获益更大。经皮选择性肾上腺动脉栓塞(SAAE)使部分肾上腺组织坏死,达到降低醛固酮水平的一种微创方法,近十几年来我国开始探索用这种方法治疗PA。本文对SAAE治疗PA进行了汇总分析,就其现状及发展前景进行阐述。

Primary aldosteronism(PA)is a common cause of secondary hypertension,and the target organ damage is often more severe and prognosis is worse in hypertension patients with PA than that in primary hypertension patients.Therefore,early diagnosis and targeted treatment of this disease are crucial to improve the outcome.Studies have found that reducing plasma aldosterone levels in PA patients is more consistent with the pathophysiological rationale than the strategy of antagonizing aldosterone receptors,and provides greater clinical benefits.Superselective adrenal arterial embolization(SAAE)is a minimally invasive method to reduce aldosterone levels by partially necrotizing the adrenal gland tissue,and researchers in China have begun to explore the use of this method to treat PA in the past decade.This commentary provides a summary analysis of SAAE treatment for PA,and discusses its current status and future prospects.