肾上腺髓样脂肪瘤伴高血压的诊断与治疗  

Diagnosis and treatment of adrenal myelolipoma with hypertension

作　　者：李浩[1] 李健[1] 彭浩[1] 葛飞[1] LI Hao;LI Jian;PENG Hao;GE Fei(Department of Urology Central Hospital of Zhoukou City,Zhoukou 466000 China)

机构地区：[1]周口市中心医院泌尿科,河南周口466000

出　　处：《河南大学学报（医学版）》2021年第3期189-193,共5页Journal of Henan University:Medical Science

摘　　要：[目的]探讨肾上腺髓样脂肪瘤(AML)合并高血压的临床诊疗特点,术后血压控制情况及影响因素。[方法]回顾性分析某医院2010年7月至2019年1月收治的14例AML合并高血压患者的临床资料,并随访术后肿瘤和血压控制情况,对患者的临床表现、实验室检查、影像学特点及术后肿瘤和血压控制情况进行分析。[结果]所有肿瘤为单侧肿瘤,平均肿瘤最大直径5.6 cm;所有患者成功通过手术切除肿瘤,围手术期血压波动正常;所有组织学标本经病理学证实为AML,随访12~80 mon未见肿瘤复发。术后4例(占比28.6%)患者血压得到控制,其中2例分别在术后2 a和3 a后再次出现血压增高,其余10例患者术后血压未恢复正常。和术后高血压缓解的患者相比,术后高血压不缓解的患者年龄要大(缓解组平均38.5岁,未缓解组平均55岁,P=0.02),术前高血压持续时间要长(缓解组平均3.63 mon,未缓解组为49.4 mon,P=0.032)。[结论]AML合并高血压患者术后血压有可能缓解,但与就诊时患者的年龄及术前高血压持续时间有关。该研究因样本量较少,存在一定局限性,需要多中心研究、大样本数据进一步验证。[Objective]To explore the clinical diagnosis and treatment of adrenal myelolipoma(AML)combined with hypertension and the postoperative blood pressure control and influencing factors.[Methods]Retrospective analysis of clinical data of 18 patients with AML and hypertension treated in a hospital from July 2010 to January 2019 and the follow-up of tumor and blood pressure control,and to analyze the clinical manifestations,laboratory examinations,imaging characteristics,and postoperative tumor and blood pressure control of patients.[Results]All tumors were unilateral tumors with an average maximum diameter of 5.6 cm;the perioperative blood pressure fluctuation of all patients was normal after successful surgical resection of tumor;all histological specimens were confirmed by pathology that there was no tumor recurrence after follow-up of 12 to 80 months in AML.The blood pressure of 4(28.6%)patients was controlled after operation,and the blood pressure of 2 cases increased again 2 years and 3 years after operation,respectively.The blood pressure of the other 10 patients did not return to normal after operation.Compared with the patients with postoperative remission of hypertension,the patients with no remission of postoperative hypertension were older(38.5 years in remission group,55 years in non-remission group,0.02 in non-remission group),and the duration of preoperative hypertension was longer(3.63 months in remission group,49.4 months in non-remission group,0.032 in non-remission group).[Conclusion]Postoperative blood pressure may be relieved in patients with AML and hypertension,but it may be related to the age of the patient at the time of consultation and the duration of preoperative hypertension.Due to the small sample size of this study,there are certain limitations,which require multi-center research and large sample data for further verification.

关 键 词：肾上腺肿瘤 髓样脂肪瘤 高血压 诊断 治疗 

分 类 号：R544.14[医药卫生—心血管疾病]