高血压和低血钾原因待查一例并文献复习  

Reasons for Hypertension Combined with Hypokalemia:Report of One Case and Literatures Review

作　　者：张景义[1] 马辰星 罗晓燕[2] 刘宁[2] 李伟[2] 赵莉莉[1] 

机构地区：[1]河北联合大学附属开滦总医院内分泌科,河北省唐山市063000 [2]河北联合大学附属开滦总医院急诊内科,河北省唐山市063000

出　　处：《中国全科医学》2013年第35期4232-4234,共3页Chinese General Practice

摘　　要：医务工作者在临床上遇到高血压伴低血钾的患者首先想到的诊断是原发性醛固酮增多症、肾血管性高血压等常见的继发性高血压原因。但是,还有一种临床症状类似原发性醛固酮增多症的继发性高血压原因通常被临床医师忽视,即Liddle综合征,其是一种常染色体显性遗传病,以高血压、低血钾、代谢性碱中毒为临床表现,临床症状类似原发性醛固酮增多症,但其血浆醛固酮水平很低,且盐皮质激素受体拮抗药螺内酯对其治疗无效,故又称为假性醛固酮增多症。本文通过1例高血压和低血钾原因待查患者对Liddle综合征的病因、临床表现、治疗方法进行讨论和分析,旨在通过本病例对Liddle综合征加以复习,使临床医师对该病的认识进一步加强。Physicians usually diagnose hypertension combined with hypokalemia first as primary aldosteronism, renal vascular hypertension and other common secondary hypertensions. But the reason for a secondary hypertension whose clinical symptoms bear a strong resemblance to primary aldosteronism is often ignored by clinical physicians, namely Liddle syndrome. It is an autosomal dominant genetic disease, performing hypertension, hypokalemia, metabolic alkalosis; its clinical symptom is like primary aldosteronism, but its plasma aldosterone level is very low. Mineralocorticoid receptor antagonist spironolactone is ineffective to it. So it is also called pseudohyperaldosteronism. This paper discusses the etiology, clinical manifestations, treat- ments of Liddle syndrome by analyzing 1 case of hypertension combined with hypokalemia, to make physicians strengthen the awareness of Liddle syndrome.

关 键 词：LIDDLE综合征 高血压 低钾血症 醛固酮增多症 

分 类 号：R544.12[医药卫生—心血管疾病]