特发性醛固酮增多症临床实践新进展  

Clinical advances of idiopathic hyperaldosteronism

作　　者：孙继源 郭宏骞[1] 张青[1] SUN Jiyuan;GUO Hongqian;ZHANG Qing(Department of Urology,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing,210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院泌尿外科,南京210008

出　　处：《临床泌尿外科杂志》2023年第9期716-722,共7页Journal of Clinical Urology

基　　金：国家自然科学基金面上项目(No:82072822)。

摘　　要：原发性醛固酮增多症(primary aldosteronism,PA)是继发性高血压最常见的发病原因之一,未能得到正确诊疗的PA可能导致严重的心血管疾病和肾脏毒性反应。临床医生应对高风险人群进行PA检测及分型诊断以确定治疗方案。单侧肾上腺切除术及使用盐皮质激素受体拮抗剂的终身药物治疗法分别是针对单侧及双侧病变的有效治疗方案。特发性醛固酮增多症(idiopathic hyperaldosteronism,IHA)是临床上PA最常见的亚型,肾上腺静脉取样(adrenal vein sampling,AVS)是PA分型诊断的金标准,但其在临床应用过程中具有诸多局限性。本文综述了IHA病因及诊疗的最新研究进展,为IHA患者的临床诊治提供新思路。Primary aldosteronism(PA)is one of the most common causes of secondary hypertension,and PA that fails to be correctly diagnosed and treated may lead to severe cardiovascular disease and nephrotoxicity.Clini-cians should perform PA testing and typing diagnosis in high-risk groups to determine treatment options.Unilat-eral adrenalectomy and lifelong medical treatment with mineralocorticoid receptor antagonists are effective treat-ment options for unilateral and bilateral lesions,respectively.Idiopathic hyperaldosteronism(IHA)is the most common subtype of PA in clinical practice.Adrenal vein sampling(AVS)is the gold standard for PA classification diagnosis,but it has many limitations in the process of clinical application.This article reviews the latest research progress in the etiology,diagnosis and treatment of IHA,providing new ideas for the clinical diagnosis and treat-ment of IHA patients.

关 键 词：原发性醛固酮增多症 肾上腺静脉取样 特发性醛固酮增多症 双侧醛固酮增多症 

分 类 号：R699.3[医药卫生—泌尿科学]