高血压合并原发性醛固酮增多症患者肾上腺超声声像回声强度与临床特征的关系  

Relationship of ultrasonographic echo intensity of adrenal gland with clinical characteristics in hypertensive patients complicated with primary hyperaldosteronism

作　　者：蓝家富[1] 梁烨[2] 李近都[3] 韦宝敏[4] 赖腾芳[4] 李天资[4] LAN Jia-fu;LIANG Ye;LI Jin-du;WEI Bao-min;LAI Teng-fang;LI Tian-zi(Department of Ultrasound,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,China;Department of Education,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,China;Department of Hepatobiliary Surgery,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,China;Department of Cardiovascular Medicine,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,China)

机构地区：[1]右江民族医学院附属医院超声科,广西百色市533000 [2]右江民族医学院附属医院教学部,广西百色市533000 [3]右江民族医学院附属医院肝胆外科,广西百色市533000 [4]右江民族医学院附属医院心血管内科,广西百色市533000

出　　处：《广西医学》2022年第2期149-153,共5页Guangxi Medical Journal

基　　金：广西中青年教师基础能力提升基金(2018KY0450);广西百色市科技基金(百科20193109);广西壮族自治区卫生健康委员会科技基金(Z2014607)。

摘　　要：目的探讨高血压合并原发性醛固酮增多症患者肾上腺超声声像回声强度与临床特征的关系。方法纳入92例高血压合并原发性醛固酮增多症的患者,均行肾上腺超声检查。根据肾上腺病变区超声声像回声强度将患者分为强回声组69例与低回声组23例。比较两组患者的性别、年龄、血压,以及血脂、空腹血糖、醛固酮、肿瘤坏死因子α(TNF-α)和白细胞介素1β水平;采用Logistic回归模型分析高血压合并原发性醛固酮增多症患者肾上腺超声声像回声强度与上述指标的相关性。结果与强回声组比较,低回声组患者的立位醛固酮水平和立卧位醛固酮水平差更高,卧位醛固酮水平和TNF-α水平更低(均P<0.05)。卧位醛固酮水平、立位醛固酮水平和TNF-α水平与高血压合并原发性醛固酮增多症患者肾上腺病灶超声回声强度相关(均P<0.05)。其中TNF-α水平升高者、卧位醛固酮水平升高者、立位醛固酮水平降低者肾上腺病灶呈强回声或等回声的概率更高。结论高血压合并原发性醛固酮增多症患者肾上腺病灶的超声回声声像特征与醛固酮水平、部分炎症因子密切相关;可根据超声特征对此类患者的临床类型进行鉴别,为个性化的临床治疗方案的制定提供参考。Objective To explore the relationship of ultrasonographic echo intensity of adrenal gland with clinical characteristics in hypertensive patients complicated with primary hyperaldosteronism.Methods Ninety-two hypertensive patients complicated with primary hyperaldosteronism were enrolled,and all patients underwent ultrasonography examination for adrenal gland.The patients were divided into hyperecho group(69 cases)and hypoecho group(23 cases)according to the ultrasonographic echo intensity in the region of adrenal lesion.The two groups were compared in terms of patients'gender,age,blood pressure,as well as the levels of blood lipid,fasting blood glucose,aldosterone,tumor necrosis factorα(TNF-α)and interleukin 1β.The Logistic regression model was used to analyze the correlation of ultrasonographic echo intensity of adrenal gland with the aforementioned indices in hypertensive patients complicated with primary hyperaldosteronism.Results Compared with the hyperecho group,patients in the hypoecho group exhibited an increased difference between the aldosterone level in the orthostatic position and the aldosterone level in the supine position,a lower aldosterone level in the supine position and a declined TNF-α level(all P<0.05).The aldosterone level in the supine position,the aldosterone level in the orthostatic position,and the TNF-α level correlated with ultrasonographic echo intensity of adrenal lesion in hypertensive patients complicated with primary hyperaldosteronism(all P<0.05).And patients with a higher TNF-α level,a higher aldosterone level in the supine position,or a lower aldosterone level in the orthostatic position were more likely to present hyperecho or isoecho on adrenal lesion.Conclusion The ultrasonographic echo characteristics of adrenal lesion closely correlate with the aldosterone level and some inflammatory factors in hypertensive patients complicated with primary hyperaldosteronism.The clinical types of such patients can be identified based on their ultrasonographic characteristics,thus pro

关 键 词：原发性醛固酮增多症 高血压 超声 回声强度 肾上腺结节性增生 醛固酮瘤 临床特征 醛固酮 炎症因子 

分 类 号：R586.24[医药卫生—内分泌]