Vetshev P S, Shkrob O S, Ippolitov L I, Polunin G V
Khirurgiia (Mosk). 2001(1):33-40.
230 patients with arterial hypertension of adrenal origin were treated. 205 of them underwent adrenalectomy with surrounding paranephral fat. There were no lethal outcomes. Endogenic adrenocorticism was diagnosed in 134 patients. Cushing's syndrom was in 96 patients, Cushing's disease--in 34, ACTH-ectopic syndrome--in 2, adrenocortical cancer--in 2. Primary hyperaldosteronism was diagnosed in 42 cases: idiopathic hyperaldosteronism in 23 patients, aldosteronproducing adenoma (Conn's syndrome)--in 19. Tumors of chromaffine tissue were defected in 30 patients. All the patients underwent complex examination (hormonal profile, US, CT, MRT, angiography if it was necessary). Symptomatic arterial hypertension of adrenal origin was diagnosed during one year in 10% patients only because of absence of typical clinical picture. Use of complex examination has permitted to make a correct topical diagnosis and to choose optimum treatment policy in all the cases.
对230例肾上腺源性高血压患者进行了治疗。其中205例行肾上腺切除术并切除周围肾旁脂肪。无死亡病例。134例患者诊断为内源性肾上腺皮质功能亢进。96例为库欣综合征，34例为库欣病，2例为促肾上腺皮质激素异位综合征，2例为肾上腺皮质癌。42例诊断为原发性醛固酮增多症：23例为特发性醛固酮增多症，19例为醛固酮瘤（康恩综合征）。30例患者发现嗜铬组织肿瘤。所有患者均接受了综合检查（激素谱、超声、CT、磁共振成像，必要时进行血管造影）。仅10%的患者在1年内诊断出肾上腺源性症状性高血压，原因是缺乏典型临床表现。综合检查的应用使得在所有病例中都能做出正确的局部诊断并选择最佳治疗方案。
