摘要
目的分析原发性醛固酮增多症(PA)患者手术治疗后血压、血钾的缓解率,探讨影响手术治疗效果可能的术前因素。方法回顾性收集自2016年1月1日-2020年8月30日期间就诊于西安交通大学第一附属医院接受手术治疗的112例PA患者的临床及随访资料。根据血压缓解情况分为血压完全缓解、部分缓解及不缓解组;根据血钾缓解情况分为血钾缓解组及不缓解组。结果(1)所有患者均患有高血压,其血压完全缓解率为56.25%(63/112),部分缓解率为39.29%(44/112),不缓解率为4.46%(5/112)。81.25%(91/112)患者有低钾血症,术后血钾缓解率为92.31%(84/91),不缓解率为7.69%(7/91)。(2)按血压缓解情况分组,与血压部分缓解组及不缓解组相比,完全缓解组更年轻、肌酐更低、肾小球滤过率(eGFR)更高、病程更短、体质量指数(BMI)更低(均P<0.05),差异均有统计学意义。其中低钾病史、eGFR是血压完全缓解的独立影响因素(OR=0.276,95%CI:0.082~0.925,P=0.037;OR=1.025,95%CI:1.008~1.042,P=0.005)。(3)与血钾不缓解组相比,缓解组单侧病变所占比例更高(92.86%vs.42.86%,P<0.05),且是血钾缓解的独立影响因素(OR=17.333,95%CI:3.129~96.010,P=0.001)。结论术前低钾病史、eGFR是血压完全缓解的独立影响因素,单侧病变比例是血钾缓解的独立影响因素。
Objective To analyze the remission rates of blood pressure and serum potassium in patients with primary aldosteronism(PA)after surgical treatment,so as to explore the efficacy of surgery and identify the possible preoperative factors affecting good outcomes.Methods The clinical and follow-up data of 112 PA patients treated in our hospital during Jan.1,2016 and Aug.30,2020 were retrospectively analyzed.According to the remission of blood pressure,the patients were divided into complete remission group,partial remission group,and non-remission group.According to the remission of serum potassium,they were divided into potassium remission group and non-remission group.Results All patients suffered from hypertension.The complete remission rate of blood pressure was 56.25%(63/112),partial remission rate was 39.29%(44/112),and non-remission rate was 4.46%(5/112).Up to 81.25%(91/112)patients had hypokalemia.The postoperative potassium remission rate was 92.31%(84/91),and the non-remission rate was 7.69%(7/91).When the patients were divided according to blood pressure,compared with the partial remission group and non-remission group,patients in the complete remission group were younger,had lower creatinine,higher estimated glomerular filtration rate(eGFR),shorter course of disease and lower body mass index(BMI)(P<0.05).The history of hypokalemia and eGFR were independent factors influencing the complete remission of blood pressure(OR=0.276,95%CI:0.082~0.925,P=0.037;OR=1.025,95%CI:1.008~1.042,P=0.005).When the patients were divided according to potassium,compared with the non-remission group,the remission group had higher proportion of unilateral lesions(92.86%vs.42.86%,P<0.05).Unilateral lesions were an independent factor of the remission of potassium(OR=17.333,95%CI:3.129~96.010,P=0.001).Conclusion Preoperative history of hypokalemia and eGFR are independent influencing factors for complete blood pressure remission,and the proportion of unilateral lesions is an independent influencing factor for serum potassium remission
作者
郭超英
童睿
郭浩楠
宋文斌
秦皓
许静
崔巍
GUO Chaoying;TONG Rui;GUO Haonan;SONG Wenbin;QIN Hao;XU Jing;CUI Wei(Department of Geriatric Endocrinology,First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Department of Urology,First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Department of Peripheral Vascular Disease,First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)
出处
《现代泌尿外科杂志》
CAS
2022年第10期816-820,826,共6页
Journal of Modern Urology
基金
陕西省社会发展科技公关项目(No.2016sf-314)
陕西省重点研发计划一般项目(No.2022SF-391)。
关键词
原发性醛固酮增多症
肾上腺切除术
血压
血钾
影响因素
primary aldosteronism
adrenalectomy
blood pressure
blood potassium
influencing factors
