天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2013年
12期
1150-1152
,共3页
醛固酮增多症%高血压%肾素%醛固酮腺瘤%单侧肾上腺增生
醛固酮增多癥%高血壓%腎素%醛固酮腺瘤%單側腎上腺增生
철고동증다증%고혈압%신소%철고동선류%단측신상선증생
hyperaldosteronism%hypertension%renin%aldosterone-producing adenoma%unilateral adrenal hyperplasia
目的：探讨高血压患者中原发性醛固酮增多症（PA）的检出率及临床特点。方法197例高血压患者检测PA及其他相关指标，排除其他继发性高血压。将研究对象分PA组及原发性高血压组（EH组）。对2组患者行卧、立位试验，卡托普利试验或静脉高钠试验，血钾及肾上腺薄层CT，部分患者行午夜地塞米松抑制试验、促肾上腺皮质激素（ACTH）及性激素测定，主要指标为血醛固酮、肾素活性及醛固酮与肾素活性比值（ARR）。结果（1）197例高血压患者中确诊PA38例（19.29%），13例经病理诊断证实，醛固酮腺瘤6例，单侧肾上腺增生7例,未发现无功能腺瘤。（2）2组患者的高血压病程及体质指数（BMI）的差异无统计学意义，PA组及EH组男性均多于女性。（3）与EH组比较，PA组的起病年龄相对年轻，收缩压与舒张压水平更高，但差异均无统计学意义；PA组卧位、立位血醛固酮水平及ARR均显著升高，血肾素活性均显著下降（均P＜0.01），血钾水平差异无统计学意义。结论同期住院的高血压患者中PA的检出率较高，其中醛固酮腺瘤和单侧肾上腺增生的比例相近，低钾血症不常见。
目的：探討高血壓患者中原髮性醛固酮增多癥（PA）的檢齣率及臨床特點。方法197例高血壓患者檢測PA及其他相關指標，排除其他繼髮性高血壓。將研究對象分PA組及原髮性高血壓組（EH組）。對2組患者行臥、立位試驗，卡託普利試驗或靜脈高鈉試驗，血鉀及腎上腺薄層CT，部分患者行午夜地塞米鬆抑製試驗、促腎上腺皮質激素（ACTH）及性激素測定，主要指標為血醛固酮、腎素活性及醛固酮與腎素活性比值（ARR）。結果（1）197例高血壓患者中確診PA38例（19.29%），13例經病理診斷證實，醛固酮腺瘤6例，單側腎上腺增生7例,未髮現無功能腺瘤。（2）2組患者的高血壓病程及體質指數（BMI）的差異無統計學意義，PA組及EH組男性均多于女性。（3）與EH組比較，PA組的起病年齡相對年輕，收縮壓與舒張壓水平更高，但差異均無統計學意義；PA組臥位、立位血醛固酮水平及ARR均顯著升高，血腎素活性均顯著下降（均P＜0.01），血鉀水平差異無統計學意義。結論同期住院的高血壓患者中PA的檢齣率較高，其中醛固酮腺瘤和單側腎上腺增生的比例相近，低鉀血癥不常見。
목적：탐토고혈압환자중원발성철고동증다증（PA）적검출솔급림상특점。방법197례고혈압환자검측PA급기타상관지표，배제기타계발성고혈압。장연구대상분PA조급원발성고혈압조（EH조）。대2조환자행와、립위시험，잡탁보리시험혹정맥고납시험，혈갑급신상선박층CT，부분환자행오야지새미송억제시험、촉신상선피질격소（ACTH）급성격소측정，주요지표위혈철고동、신소활성급철고동여신소활성비치（ARR）。결과（1）197례고혈압환자중학진PA38례（19.29%），13례경병리진단증실，철고동선류6례，단측신상선증생7례,미발현무공능선류。（2）2조환자적고혈압병정급체질지수（BMI）적차이무통계학의의，PA조급EH조남성균다우녀성。（3）여EH조비교，PA조적기병년령상대년경，수축압여서장압수평경고，단차이균무통계학의의；PA조와위、립위혈철고동수평급ARR균현저승고，혈신소활성균현저하강（균P＜0.01），혈갑수평차이무통계학의의。결론동기주원적고혈압환자중PA적검출솔교고，기중철고동선류화단측신상선증생적비례상근，저갑혈증불상견。
Objective To study the detection rate and characteristics of primary aldosteronism (PA) in patients with hypertension. Methods A total of 197 patients with hypertension were enrolled and underwent PA and other related exami-nation to exclude the secondary hypertension. Patients were divided into two groups: PA group and essential hypertension (EH) group. The upright position test, supine position test, captopril test, venous high sodium test, potassium concentration examination and adrenal CT scanning were detected in two groups. Values of blood aldosterone, renin activity and aldoste-rone to renin activity ratio (ARR) were detected in some patients. Results (1) In 197 hypertensive patients, 38 were diag-nosed as PA (19.29%), 13 were confirmed by pathology, (6 cases aldosterone-producing adenoma and 7 unilateral adrenal hyperplasia). (2) There were no significant differences in the history of hypertension and body mass index (BMI) between two groups. There were more male patients than female patients in both groups. (3) Compared with EH group, there were relative-ly young age of onset, higher levels of systolic and diastolic blood pressure in PA group, but the difference was not statistical-ly significant (P>0.05). The levels of blood aldosterone and ARR were significantly increased in upright position and supine position in PA group (P<0.01), but the blood level of renin activity was significantly decreased(P<0.01). There was no sig-nificant significance in blood potassium level between two groups. Conclusion There was a higher detection rate of PA in patients hospitalized with hypertension. The detection rate of aldosterone-producing adenoma was similar to that of unilater-al adrenal hyperplasia in patients with PA. The hypokalemia was uncommon.
