CAJ | 학술논문

目的以优先应用肾上腺薄层CT扫描的方法,在门诊高血压患者中筛查肾上腺病变的患病情况,评价该方法在高血压人群早期诊断肾上腺高血压的应用价值.方法本研究对象来自本院心内科门诊患者(2009年1月至2009年8月),排除已知继发性高血压(包括已诊断的内分泌及肾性高血压)和恶性肿瘤.应用肾上腺薄层CT进行筛查,对于肾上腺形态学异常者进一步完善其肾上腺病变的各项内分泌功能检查,得出肾上腺病变和肾上腺高血压的检出率,从而评价影像学优先筛查策略的诊断价值.结果入选高血压患者362例,其中男性162例,女性200例,平均年龄(60.9±9.3)岁,平均高血压病程为(13.8±5.3)年.经肾上腺薄层CT扫描发现,肾上腺形态学异常35例(9.6％),其中肾上腺腺瘤20例(5.5％),肾上腺增生15例(4.1％).经内分泌功能评价结果发现,从35例肾上腺形态异常者中确认肾上腺高血压患者17例,肾上腺高血压总检出率为4.7％,其中原发性醛固酮增多症14例(3.9％),皮质醇增多症2例(0.6％),嗜铬细胞瘤1例(0.3％).优先应用肾上腺薄层CT扫描在门诊高血压患者中检出肾上腺形态学异常率为9.6％,联合功能评价,肾上腺性高血压总检出率为4.7％.结论影像检查优先的策略在门诊高血压患者中筛查肾上腺高血压具有良好的应用价值.
목적 이우선응용신상선박층CT소묘적방법,재문진고혈압환자중사사신상선병변적환병정황,평개해방법재고혈압인군조기진단신상선고혈압적응용개치.방법 본연구대상래자본원심내과문진환자(2009년1월지2009년8월),배제이지계발성고혈압(포괄이진단적내분비급신성고혈압)화악성종류.응용신상선박층CT진행사사,대우신상선형태학이상자진일보완선기신상선병변적각항내분비공능검사,득출신상선병변화신상선고혈압적검출솔,종이평개영상학우선사사책략적진단개치.결과 입선고혈압환자362례,기중남성162례,녀성200례,평균년령(60.9±9.3)세,평균고혈압병정위(13.8±5.3)년.경신상선박층CT소묘발현,신상선형태학이상35례(9.6％),기중신상선선류20례(5.5％),신상선증생15례(4.1％).경내분비공능평개결과발현,종35례신상선형태이상자중학인신상선고혈압환자17례,신상선고혈압총검출솔위4.7％,기중원발성철고동증다증14례(3.9％),피질순증다증2례(0.6％),기락세포류1례(0.3％).우선응용신상선박층CT소묘재문진고혈압환자중검출신상선형태학이상솔위9.6％,연합공능평개,신상선성고혈압총검출솔위4.7％.결론 영상검사우선적책략재문진고혈압환자중사사신상선고혈압구유량호적응용개치.
Objective To evaluate the priority application of thin adrenal CT scanning in out-patients with hypertension for early diagnosis of adrenal hypertension.Methods The patients with hypertension were collected from January to August 2009,in whom the secondary hypertension ( including endocrine and renal hypertension) and malignant cancers were excluded.All patients accepted the adrenal CT scan firstly,and then the patients with the positive result of morphological abnormalities in the adrenal CT( including adenoma and hyperplasia)were evaluated for endocrine function of adrenal glands.Results A total 362 cases of hypertension were studied,in.cluding 162 males and 200 females.The average age was (60.9 ±9.3 ) year-old,the average duration of hypertension was ( 13.8 ±5.3 ) year.After adrenal thin layer scanner CT scan,35 patients ( 9.6％ ) with adrenal abnormalities were found.Endocrine functional assessments of adrenal glands were carried out among these patients,17 cases (4.7％) with functional lesions were diagnosed,including 14 cases(3.9％ )with primary hyperaldosteronism,2 cases(0.6％ )with Cushing's syndrome,and 1 case ( 0.3％ ) with pheochromocytoma.Conclusion This study revealed that the percentage of adrenal lesions in outpatients with hypertension was 9.6％.The percentage of adrenal hypertension was 4.7％.Thin layer CT scan seems to effectively screen the adrenal hypertension with adrenal lesions,and would be helpful to the diagnosis of endocrine hypertension.