Sokolova R I, Volkov V I, Bulkina O S, Zhdanov V S
A. L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research Center, Moscow.
Arkh Patol. 1999 May-Jun;61(3):11-4.
Autopsy and operative material (adrenalectomy for hyperaldosteronism) was studied to elucidate morphology, incidence of nodules, aldosterone content in the adrenal of patients with essential hypertension (EH). It was established than nodular masses in the adrenals in the form of micro and macronodules are present in 80% of EH patients. Aldosterone content in the adrenals in both nodules and in the adjacent cortex is significantly higher than in the adrenals of patients without EH. This fact as well as increased cell nuclei size in the fascicular and glomerular zones indicate high secretory activity of the adrenals in EH. Clinicomorphological comparisons in patients after adrenalectomy because of hyperaldosteronism syndrome allow to conclude that grave forms of EH may be followed by aldosteronism syndromes with nodular hyperplasia of the adrenal cortex being the basis of the syndrome. Indications to adrenalectomy require clear criteria of differential diagnosis with primary aldosteronism.
对尸检和手术材料(因醛固酮增多症而行肾上腺切除术)进行了研究,以阐明原发性高血压(EH)患者肾上腺的形态、结节发生率及醛固酮含量。结果发现,80%的EH患者肾上腺存在微结节和大结节形式的结节性肿块。结节及相邻皮质中肾上腺的醛固酮含量显著高于无EH患者的肾上腺。这一事实以及束状带和球状带细胞核大小增加表明EH患者肾上腺的分泌活性较高。对因醛固酮增多症综合征行肾上腺切除术后患者的临床形态学比较表明,严重的EH形式可能继之以醛固酮增多症综合征,肾上腺皮质结节性增生是该综合征的基础。肾上腺切除术的指征需要与原发性醛固酮增多症进行明确鉴别诊断的标准。