中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
31期
3717-3719
,共3页
原发性醛固酮增多症%醛固酮瘤%特发性醛固酮增多症%原发性肾上腺增生%临床特征%随访
原髮性醛固酮增多癥%醛固酮瘤%特髮性醛固酮增多癥%原髮性腎上腺增生%臨床特徵%隨訪
원발성철고동증다증%철고동류%특발성철고동증다증%원발성신상선증생%림상특정%수방
Primary aldosteronism%Aldosterone - producing ademona%Idiopathic hyperaldosteronism%Primary adre-nal hyperplasia%Clinical features%Follow - up
目的：评价多种类型原发性醛固酮增多症（简称原醛症）患者临床特征及其术后的变化情况。方法纳入1998-2010年在上海中国人民解放军第四一一医院内分泌科诊治的原醛症患者99例，其中醛固酮瘤（APA）57例，特发性醛固酮增多症（IHA）26例，原发性肾上腺增生（PAH）16例。检测血钾、血/尿醛固酮及血浆肾素活性，将所得结果与29例原发性高血压（EH）患者及29例正常对照者进行比较。所有原醛症患者经手术治疗并进行术后随访，所得资料与术前比较。结果（1）APA、IHA、PAH 及 EH 组收缩压及舒张压均高于对照组，APA、IHA 及 PAH组血、尿醛固酮均高于 EH 及对照组，血钾、血浆肾素活性基础及激发值则低于 EH 及对照组，差异有统计学意义（P<0.05）。（2）APA 及 PAH 患者术后收缩压、舒张压、血/尿醛固酮下降，血钾则升高，与术前比较差异有统计学意义（P <0.05）。IHA 患者术后仅血钾较术前有升高，差异有统计学意义（P <0.05），其余各指标无改善，差异无统计学意义（P >0.05）。IHA 患者术后收缩压、舒张压、血/尿醛固酮高于 APA 及 PAH 患者，血钾则低于 APA 及 PAH 患者，差异有统计学意义（P <0.05）。结论原醛症患者可表现为高血压、低血钾、高血/尿醛固酮及血钾肾素活性受抑，APA 及 PAH 患者手术治疗有一定疗效，而 IHA 患者手术治疗效果不理想。
目的：評價多種類型原髮性醛固酮增多癥（簡稱原醛癥）患者臨床特徵及其術後的變化情況。方法納入1998-2010年在上海中國人民解放軍第四一一醫院內分泌科診治的原醛癥患者99例，其中醛固酮瘤（APA）57例，特髮性醛固酮增多癥（IHA）26例，原髮性腎上腺增生（PAH）16例。檢測血鉀、血/尿醛固酮及血漿腎素活性，將所得結果與29例原髮性高血壓（EH）患者及29例正常對照者進行比較。所有原醛癥患者經手術治療併進行術後隨訪，所得資料與術前比較。結果（1）APA、IHA、PAH 及 EH 組收縮壓及舒張壓均高于對照組，APA、IHA 及 PAH組血、尿醛固酮均高于 EH 及對照組，血鉀、血漿腎素活性基礎及激髮值則低于 EH 及對照組，差異有統計學意義（P<0.05）。（2）APA 及 PAH 患者術後收縮壓、舒張壓、血/尿醛固酮下降，血鉀則升高，與術前比較差異有統計學意義（P <0.05）。IHA 患者術後僅血鉀較術前有升高，差異有統計學意義（P <0.05），其餘各指標無改善，差異無統計學意義（P >0.05）。IHA 患者術後收縮壓、舒張壓、血/尿醛固酮高于 APA 及 PAH 患者，血鉀則低于 APA 及 PAH 患者，差異有統計學意義（P <0.05）。結論原醛癥患者可錶現為高血壓、低血鉀、高血/尿醛固酮及血鉀腎素活性受抑，APA 及 PAH 患者手術治療有一定療效，而 IHA 患者手術治療效果不理想。
목적：평개다충류형원발성철고동증다증（간칭원철증）환자림상특정급기술후적변화정황。방법납입1998-2010년재상해중국인민해방군제사일일의원내분비과진치적원철증환자99례，기중철고동류（APA）57례，특발성철고동증다증（IHA）26례，원발성신상선증생（PAH）16례。검측혈갑、혈/뇨철고동급혈장신소활성，장소득결과여29례원발성고혈압（EH）환자급29례정상대조자진행비교。소유원철증환자경수술치료병진행술후수방，소득자료여술전비교。결과（1）APA、IHA、PAH 급 EH 조수축압급서장압균고우대조조，APA、IHA 급 PAH조혈、뇨철고동균고우 EH 급대조조，혈갑、혈장신소활성기출급격발치칙저우 EH 급대조조，차이유통계학의의（P<0.05）。（2）APA 급 PAH 환자술후수축압、서장압、혈/뇨철고동하강，혈갑칙승고，여술전비교차이유통계학의의（P <0.05）。IHA 환자술후부혈갑교술전유승고，차이유통계학의의（P <0.05），기여각지표무개선，차이무통계학의의（P >0.05）。IHA 환자술후수축압、서장압、혈/뇨철고동고우 APA 급 PAH 환자，혈갑칙저우 APA 급 PAH 환자，차이유통계학의의（P <0.05）。결론원철증환자가표현위고혈압、저혈갑、고혈/뇨철고동급혈갑신소활성수억，APA 급 PAH 환자수술치료유일정료효，이 IHA 환자수술치료효과불이상。
Objective The purpose of the study was to assess clinical characteristics of patients with different types of primary aldosteronism(PA)and the changes after operation. Methods Ninety - nine patients of primary aldosteronism〔inclu-ding 57 patients with aldosterone - producing ademona(APA),26 patients with idiopathic hyperaldosteronism(IHA)and 16 patients with primary adrenal hyperplasia(PAH)〕treated in our hospital were involved in the study. Plasma potassium,serum/urinary aldosterone and plasma renin activity(PRA)were measured and the results were compared with those of 29 patients of es-sential hypertension(EH)and 29 in normal control group. All patients of PA were treated with operation and followed up after op-eration and the result was compared with that before operation. Results (1)The systolic and diastolic blood pressure(SBP, DBP)were all higher in APA,IHA,PAH and EH patients than those of control group. The plasma and urinary aldosterone were higher in APA,IHA and PAH patients than those of EH and control groups while the plasma potassium,basal and activated PRA were lower and the differences were significant(P < 0. 05). (2) The SBP,DBP,plasma and urinary aldosterone were de-creased in patients of APA and PAH after operation and the plasma potassium was increased;the differences were statistically sig-nificant from those before operation(P < 0. 05). Only plasma potassium was increased in IHA patients after operation and the difference was significant(P < 0. 05)and no improvements were found in other indexes with significant difference(P > 0. 05). The SBP,DBP,plasma and urinary aldosterone in IHA patients were higher than those of APA and PAH groups after operation and the plasma potassium was lower with significant difference(P < 0. 05). Conclusion Primary aldosteronism may manifest as high blood pressure,hypokalemia,high plasma and urinary aldosterone,inhibition of plasma renin activity. Operation can have certain curative effects on patients with APA and PAH,but not on patients with IHA.
