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[一组门诊高血压患者中原发性醛固酮增多症的发生情况]

[Occurrence of primary aldosteronism in a group of ambulatory hypertensive patients].

作者信息

Kreze A, Okálová D, Vanuga P, Putz Z, Kodaj J, Hrnciar J

机构信息

Interná klinika A NFDR, Banská Bystrica.

出版信息

Vnitr Lek. 1999 Jan;45(1):17-21.

Abstract

Findings pertaining to the diagnosis and treatment of primary aldosteronism are rapidly expanding. In the present work the authors focused attention on the clinical application of some progressive methods. They examined a group of 115 ambulatory patients with arterial hypertension, not suspected of secondary arterial hypertension, in the course of one year. As a screening method of primary aldosteronism they selected the aldosterone renin ratio (ARR). Using this method the authors diagnosed 125 cases of primary aldosteronism, i.e. a 13% prevalence in the examined group. Only in one instance they detected an adenoma by computed tomography (CT), in the remaining patients, i.e. four times, the adenoma was verified by selective catheterization of adrenal veins and assessment of aldosterone and cortisol. The authors did not confirm a more accurate localization of the adenoma by the aldosterone/cortisol ration than when assessing aldosterone only. In two patients adrenalectomy was performed by laparoscopy and this surgical technique, as regards adrenal glands, was implemented for the first time in Slovakia in our department. It has certain advantages over classical adrenalectomy.

摘要

有关原发性醛固酮增多症诊断和治疗的研究结果正在迅速扩展。在本研究中,作者将注意力集中在一些先进方法的临床应用上。他们在一年的时间里对一组115例未怀疑继发性高血压的门诊高血压患者进行了检查。作为原发性醛固酮增多症的筛查方法,他们选择了醛固酮肾素比值(ARR)。通过这种方法,作者诊断出125例原发性醛固酮增多症,即在被检查组中的患病率为13%。仅在1例中通过计算机断层扫描(CT)检测到腺瘤,在其余患者中,即4例,通过肾上腺静脉选择性插管及醛固酮和皮质醇评估证实了腺瘤。作者并未证实与仅评估醛固酮时相比,通过醛固酮/皮质醇比值能更准确地定位腺瘤。在2例患者中通过腹腔镜进行了肾上腺切除术,这种针对肾上腺的手术技术在我们科室于斯洛伐克首次实施。它相对于传统肾上腺切除术具有某些优势。

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