肾上腺病变合并高血压患者术后血压改善情况及其影响因素  

Improvement of postoperative blood pressure in patients with adrenopathy and concomitant hypertension and its influencing factors

作　　者：李瑞宝 李碧君 黄海文 莫方胜 农毅 陈丽霞 陈秋晓 LI Ruibao;LI Bijun;HUANG Haiwen;MO Fangsheng;NONG Yi;CHEN Lixia;CHEN Qiuxiao(Department of Urology Surgery,the Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524003,Guangdong,China;Department of Urology Surgery,Central People′s Hospital of Zhanjiang,Zhanjiang 524000,Guangdong,China;Department of Urology Surgery,Guangdong Agricultural Reclamation Central Hospital,Zhanjiang 524000,Guangdong,China;Operating Room,the Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524003,Guangdong,China)

机构地区：[1]广东医科大学附属第二医院泌尿外科,广东省湛江市524003 [2]湛江市中心人民医院泌尿外科,广东省湛江市524000 [3]广东省农垦中心医院泌尿外科,广东省湛江市524000 [4]广东医科大学附属第二医院手术室,广东省湛江市524003

出　　处：《广西医学》2023年第10期1163-1167,共5页Guangxi Medical Journal

基　　金：广东省湛江市科技计划项目(2021B01349)。

摘　　要：目的分析肾上腺病变合并高血压患者术后血压改善情况及其影响因素。方法选择进行手术治疗的74例肾上腺病变合并高血压患者,根据出院时的血压情况将其分为术后血压正常组(n=53)与术后高血压组(n=21)。比较两组患者的一般临床资料,以及不同时间点的血压、血钾水平及卧位血浆醛固酮水平。采用多因素Logistic回归模型分析肾上腺病变合并高血压患者术后血压改善情况的影响因素。结果患者术后血压改善率为71.62%。术后1个月、3个月、6个月、12个月,两组患者的收缩压、舒张压及卧位血浆醛固酮水平均低于术前,血钾水平均高于术前,且术后血压正常组患者的收缩压均低于术后高血压组(均P<0.05)。多因素Logistic回归分析结果显示,年龄、体质指数、高血压病程、高血压分级均是肾上腺病变合并高血压患者术后血压改善情况的影响因素(均P<0.05)。结论肾上腺病变合并高血压患者术后血压可获得一定改善,年龄、体质指数、高血压病程、高血压分级均是患者术后血压改善情况的影响因素。Objective To analyze the improvement of postoperative blood pressure in patients with adrenopathy and concomitant hypertension and its influencing factors.Methods Seventy-four patients with adrenopathy and concomitant hypertension undergoing surgical treatment were selected,and they were assigned to postoperative normal blood pressure group(n=53)or postoperative hypertension group(n=21)according to the blood pressure at discharge.The general clinical data,and blood pressure,blood potassium level,and decumbent plasma aldosterone level at different time points were compared between the two groups.The influencing factors for the improvement of postoperative blood pressure in patients with adrenopathy and concomitant hypertension were analyzed by employing the multivariate Logistic regression model.Results The improvement rate of postoperative blood pressure in patients was 71.62%.At 1,3,6,and 12 months after operation,the systolic and diastolic blood pressure,decumbent plasma aldosterone level were lower as compared with before operation,and blood potassium level was higher as compared with before operation;furthermore,the systolic blood pressure was lower in the postoperative normal blood pressure group than in the postoperative hypertension group(all P<0.05).The results of multivariate Logistic regression analysis revealed that age,body mass index,disease course of hypertension,and hypertension classification were the influencing factors for the improvement of postoperative blood pressure in patients with adrenopathy and concomitant hypertension(all P<0.05).Conclusion Blood pressure can be ameliorated to a certain extent in patients with adrenopathy and concomitant hypertension after operation,and age,body mass index,disease course of hypertension,and hypertension classification are the influencing factors for the improvement of postoperative blood pressure in patients.

关 键 词：肾上腺病变 高血压 醛固酮 血钾 影响因素 

分 类 号：R736.6[医药卫生—肿瘤]