单侧肾上腺结节性原发性醛固酮增多症的诊断与预后（附27例分析）  

The diagnosis and result of unilateral nodular adrenal hyperplasia in primary aldosteron- ism： study of 27 cases

作　　者：胡岚亭[1] 汪加朋[1] 汪清[1] 

机构地区：[1]新疆维吾尔自治区人民医院泌尿二科,乌鲁木齐830012

出　　处：《国际泌尿系统杂志》2012年第3期326-329,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨单侧肾上腺结节性原发性醛固酮增多症的几种诊断方法的阳性率及治疗效果。方法回顾性分析2006年1月至2011年1月经手术及病理确诊的单侧肾上腺皮质结节增生性原发性醛固酮增多症患者27例，男13例，女14例。以头痛头晕就诊22例，体检发现肾上腺占位就诊5例。27例患者均有高血压病史，患病时间中位时间2年（1个月～24年）。所有患者均行肾上腺B超及薄层CT扫描，其中行肾上腺静脉采血（AVS）检查16例。结果：B超、CT及AVS采血阳性率分别为66．7％、92．6％、93．8％。2例行开放，25例行经后腹腔镜患侧肾上腺切除术，术后随访20例，18例术后6个月内血压恢复正常；2例6个月后血压控制不理想，1例需2种以上降压药物联合降压。结论单侧。肾上腺皮质结节增生性原发性醛固酮增多症是一种可以通过手术治愈的疾病，需要反复检测血浆醛固酮及肾素等，CT及肾上腺静脉采血是其术前分型定侧诊断的重要手段。Objectives To investigate the diagnosis and result of unilateral nodular adrenal hyperplasia in primary aldosteronism（ UNAH）. Methods From January 2006 to January 2011, we retrospective study 27 cases of UNAH by pathological results. There were 13 males and 14 females with a clinical symptoms of headache and dizziness in 22 cases, a physical examination of adrenal masses in 5 cases. All patients presented arterial hypertension for a mean time of 24 months （ 1 months to 24 years） and underwent adrenal ultrasound and MSCT, 16 cases underwent adrenal venous sampling（AVS）. Results The accuracy rate of ultrasound, computed tomography （CT） and AVS rate were 66.7%, 92.6% and 93.8% respectively. Laparoscopie ipsilateral adrenaleetomy was performed in 25 cases while open surgery in 2 cases. 20 eases were follow up after UNAH operation in 6 months, the blood pressure of 18 cases were returned to normal, 2 eases were controlled unsatisfactory and one case need taking two antihy- pertensive drugs. Conclusions UNAH can he cured by adrenal surgery, requiring repeated testing plasma aldo- sterone and rennin. CT and AVS are the most important technology and methods in diagnosis of UNAH pre - operation.

关 键 词：醛固酮增多症 肾上腺疾病 

分 类 号：R586.24[医药卫生—内分泌]