高血压患者中原发性醛固酮增多症的检出率及特点  

Positive rates and symptoms of primary aldosteronism among patients with hypertension

作　　者：万程彬[1] 

机构地区：[1]河南省南阳市第二人民医院,河南南阳473012

出　　处：《中国伤残医学》2015年第16期26-27,共2页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：分析探讨高血压患者中原发性醛固酮增多症的检出率及特征。方法：选取122例高血压患者作为研究对象，对本组患者实施醛固酮增多症检测以及其他指标的检测，从而有效的排除其他继发性高血压患者。将该122例患者分为醛固酮增多症组和原发性高血压组；2组患者均实施卧、立位试验，血钾及肾上腺薄层CT检测，同时一部分患者实施午夜地塞米松抑制试验、促肾上腺皮质激素及性激素测定，对患者主要观察的指标有血醛固酮、醛固酮与肾素活性比值以及肾素活性等。结果：2组患者中共有24例患者被确诊为原发性醛固酮增多症，所占比例为19．67％，此外并未发现无功能腺瘤；2组患者在一般资料上无显著性差异，但原发性醛固酮增多症组在卧、立位血醛固酮及醛固酮与肾素活性比值均发生显著升高，而血肾素活性出现明显下降，差异显著性（P＜0．05），在血钾水平上则无较大差异（P＞0．05）。结论：在同一时期住院的高血压患者中原发性醛固酮症有着较高的检出率，这其中以醛固酮腺瘤和单侧肾上腺增生的比值较为接近。Objective：To analyze the positive rates and the symptoms of primary aldosteronism among patients with hypertension. Methods：Select 122 patients with hypertension as the research object, and analyze the positive rate of aldosteronism and other indicators for these patients to ruled out other secondary hypertension patients effectively.The 122 patients were randomly divided into two groups：aldosteronism and primary hypertension group;both were given lying and standing tests on serum potassium and adrenaline thin-layer CT scanning .Meanwhile, some patients were given a midnight Dexamethasone suppression test and a adrenocorticotropic and sexhormone test to study the indicators such as aldosterone level , the aldosterone and renin activity ratio ect.Results：A total of 24 patients in two groups of patients were diagnosed with primary aldosteronism, accounting for 19.67%of all the patients, while no evidence in non-functional adenomas was found;Two groups of patients had no significant differences in general information, but in the primary aldosteronism group, there was a significant increase in aldosterone level and the aldosterone and renin activity ratio as well as a obvious decline in plasma renin activity in lying and standing tests.The difference was very significant （ P 〈0.05） , while there was no significant difference （ P 〉0. 05）on the potassium levels.Conclusion：The positive rate of primary aldosteronism might be relatively high among the patients with hypertension , and among them the rate of aldosteronoma and adrenal hyperplasia might be very close.

关 键 词：高血压患者 原发性醛固酮增多症 检出率及临床特点 

分 类 号：R544.1[医药卫生—心血管疾病]