摘要
目的:探讨原发性醛固酮增多症(原醛)的生化特点。方法:分析64例原醛患者的临床特点和手术前后实验室检验结果的变化。结果:64例中,醛固酮瘤(APA)47例(73.4%),特发性醛固酮增多症(IHA)15例(23.4%),原发性肾上腺皮质增生(PAH)2例(3.2%)。56例(87.5%)有不同程度的高血压。术前低血钾56例(87.5%),APA患者严重低血钾发生率高于IHA(P<0.01);血浆醛固酮升高55例(85.9%),血浆低肾素48例(75.0%);APA和IHA组高醛固酮和低肾素发生率相似(P>0.05)。5例高血压、血钾、醛固酮正常的APA患者,血醛固酮/肾素活性比值(PAC/PRA)>30。术后平均随访20.4个月,APA和IHA患者术后血钾恢复正常率无统计学意义(P>0.05);高血压治愈和缓解率APA优于IHA(P<0.05);手术有效的患者血醛固酮、血醛固酮/肾素活性比值均恢复正常。术前低肾素患者高血压治愈率高于肾素正常者(P<0.05)。结论:血钾、血浆肾素、醛固酮测定是诊断原发性醛固酮增多症的主要指标,血醛固酮/肾素活性比值有助于原醛的早期诊断。实验室检验对于术后疗效随访和预后评估有重要意义。
Objective：To study the biochemical characteristics of primary aldosteronism（PA）.Methods：Clinical features and laboratory findings changes before and after operations were analyzed in 64 cases of PA.Results：In 64 cases,47 cases（73.4%）were aldosterone-producing adenomas（APA）,15 cases（23.4%） were idiopathic hyperaldosteronism（IHA） and two cases（3.2%）were primary adrenal cortex hyperplasia（PAH）.56 cases（87.5%）had different degree of hypertension,56 cases（87.5%）had hypokalemia,the rate of hypokalemia of APA higher than IHA（P0.01）;Plasma aldosterone concentration（PAC） increased in 55 cases（85.9%）,plasma renin activity（PRA） decreased in 48 cases（75.0%）.5 cases subclinical APA had normal blood pressure,potassium and aldosterone,but had PAC and PRA ratio（PAC/PRA）≥30.At a mean follow-up of 20.4 months（5~108）,postoperative serum potassium returned rate had no significant difference between APA and IHA（P0.05）,Hypertension cured and remission rate of APA is better than IHA（P0.05）.Plasma aldosterone and PAC/PRA ratio were recovered in effective operation patients.The cure rate of hypertension was higher in the low plasma renin group than that in normal plasma renin group（P0.05）.Conclusions：Mensuration of plasma potassium,aldosterone concentration（PAC） and renin activity（PRA） are important for diagnosing of primary aldosteronism.PAC/PRA ratio is a useful means for early diagnosis of this disease.Laboratory test for postoperative follow-up and prognosis assessment has important significance.
出处
《内蒙古医学杂志》
2011年第7期789-791,共3页
Inner Mongolia Medical Journal
