摘要
目的观察增生型原发性醛固酮增多症(原醛症)患者的临床、生化特征及其治疗后的变化情况。方法选取85例增生型原醛症患者〔其中特发性原醛症(IHA)69例,原发性肾上腺增生(PAH)16例〕,分为IHA手术治疗组(26例)、IHA非手术治疗组(43例)和PAH组(16例)。分析3组患者的血压,血、尿醛固酮,血钾及血浆肾素活性(PRA)间的差异,并对患者术后或治疗后随访资料进行分析。3组计量资料的比较采用方差分析,组间两两比较采用q检验。结果 (1)IHA手术治疗组、IHA非手术治疗组、PAH组高醛固酮血症者分别占100.0%(26/26)、79.1%(34/43)及93.8%(15/16),低血钾者分别占76.9%(20/26)、62.8%(27/43)及75.0%(12/16)。诊断时IHA手术治疗组及PAH组患者血、尿醛固酮及血钾水平与IHA手术治疗组比较,差异均有统计学意义(P<0.05)。(2)IHA手术治疗组患者术后随访及IHA非手术治疗组患者药物治疗后随访,收缩压、舒张压、血醛固酮、尿醛固酮水平与诊断时比较,差异均无统计学意义(P>0.05)。PAH组患者术后随访时收缩压、舒张压、血醛固酮、尿醛固酮水平均较诊断时显著下降,血钾则显著升高,差异有统计学意义(P<0.05)。结论 PAH手术治疗患者随访中临床及生化指标改变较IHA患者明显,手术治疗有一定疗效,而IHA患者治疗效果不理想。
Objective To observe clinical and biochemical characteristics and changes after treatment in patients with adrenal hyperplasia in primary aldosteronism Methods 85 patients with adrenal hyperplasia in primary aldosteronism were selected, among which 69 cases were idiopathic hyperaldosteronism （IHA） and 16 cases were primary adrenal hyperplasia （PAH）. All the patients were divided into IHA operation group （26 cases）, IHA non -operation group （43 cases） and PAH group （16 cases） . The differences of blood pressure, plasma and urinary aldosterone, plasma potassium, PRA and prognostic data between the two groups were analyzed. Analysis of variance was used to compare the data of three groups and q test was used for pairwise comparison. Results （ 1 ） The incidence of hyperaldosteronemia in IHA operation group, IHA non - operation group and PAH group was 100.0% （26/26）, 79. 1% （34/43） and 93.8% （15/16） respectively, and the incidence of hypokalemia was 76. 9% （20/26）, 62. 8% （27/43） and 75.0% （12/16） respectively. Plasma and urinary aldosterone and plasma potassium at diagnosis of the IHA operation group and PAH group showed statistically significant differences compared with those of the IliA non - operation group （P 〈 0. 05） . （2） The SBP, DBP, plasma and urinary aldosterone of the IHA operation ＂group and IHA non - operation group during prognosis showed no statistically significant differences compared with those at diagnosis （ P 〈 0. 05） . While the SBP, DBP, plasma and urinary aldosterone of the PAH group during prognosis were significantly decreased compared with those at diagnosis, but plasma potassium was significantly increased （ P 〉 0. 05 ） . Conclusion PAH patients treated by operation have more significant improvement in clinical and biochemical indexes compared with IHA patients, indicating operation is to some extent effective, but not necessarily among IHA patients.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第30期3513-3515,共3页
Chinese General Practice
关键词
醛固酮增多症
肾上腺增生
外科手术
随访研究
Hyperaldosteronism
Adrenal hyperplasia
Surgical procedures, operative
Follow - up studies
