CAJ | 학술논문

目的探讨原发性醛固酮增多症(primary adosteronism,PA)的特点、诊断及治疗要点,以提高诊治水平.方法对我院31例术后病理确诊PA的临床资料进行总结,并结合文献分析.结果 31例均行手术治疗,其中肾上腺腺瘤28例,肾上腺皮质增生3例;以高血压为首发症状最多,低血钾表现次之;血浆醛固酮浓度/血浆肾素活性均>25/1;29例行后腹腔镜手术切除病灶及肾上腺组织,2例因自体瘤大行开放手术.结论 PA病程长,早期无特异临床症状,易误诊.ARR试验筛查可早期发现PA,CT扫描在定位及定性方面均优于B超,后腹腔镜手术是有效治疗手段,治疗效果良好.
목적 탐토원발성철고동증다증(primary adosteronism,PA)적특점、진단급치료요점,이제고진치수평.방법 대아원31례술후병리학진PA적림상자료진행총결,병결합문헌분석.결과 31례균행수술치료,기중신상선선류28례,신상선피질증생3례;이고혈압위수발증상최다,저혈갑표현차지;혈장철고동농도/혈장신소활성균>25/1;29례행후복강경수술절제병조급신상선조직,2례인자체류대행개방수술.결론 PA병정장,조기무특이림상증상,역오진.ARR시험사사가조기발현PA,CT소묘재정위급정성방면균우우B초,후복강경수술시유효치료수단,치료효과량호.
Objective To approach the characteristics, diagnosis and treatment of primary aldosteronism for improving the level of diagnosis and treatment. Methods The data of 31 cases of pathologically confirmed primary aldosteronism seen from 2005 to 2009 were collected and analysed with literature. Results 31 patients included 28 cases of aldosterone-producing adenoma,3 cases of adrenocortical hyperplasia. Most patients had high blood pressure as the first symptom, followed by the manifestation of hypokalemia. Plasma aldosterone concentration/plasma renin activity was＞25/1; in all patients 29 cases underwent laparoscopic surgery to remove lesions or adrenal tissue and 2 cases had open surgery because of the size of tumor. Conclusions This disease has a long course with non-specific clinical symptoms at the early stage, and easily be misdiagnosed. ARR screening test could detect PA early. CT scan is better than B-mode ultrasonography in both lesion location and qualitation. Retroperitoneal laparoscopic surgery is an effective treatment with satisfactory therapeutic outcome.