Ustinova S E, Sokolova R I, Levitskaia Iu V, Obtrakht N V, Gorbacheva O N, Bulkina O S
Kardiologiia. 1990 Jul;30(7):8-11.
The plasma aldosterone (A) and desoxycorticosterone (DOCS) levels were measured in 10 patients with primary aldosteronism and in 2 subgroups with low-renin hypertensive disease (LRHD): (1) those with normal adrenal glands++ (n - 11) and (2) those with structural changes in the cortex (n - 11). The patients from Subgroup 1 showed the lowest basal A and DOCS levels (107.29 +/- 12.90 and 0.080 +/- 0.013 ng/ml, respectively) and low concentrations of the two hormones after stimulation of 4-hour walk (211.57 +/- 30.47 and 0.095 +/- 0.024 ng/mg, respectively). In the patients from Subgroup 2, the basal and 4-hour post-walk++ A and DOCS contents were increased in the cortex (basal 201.50 +/- 41.59 and 0.177 +/- 0.36 ng/mg and poststimulation 331.33 +/- 30.47 and 0.302 +/- 0.061 ng/ml, respectively). Some patients with primary aldosteronism displayed the same DOCS response to stimulation as did those with LRHD in the presence of structural cortical changes. Histological examination of operative biopsy specimens indicated that higher DOCS levels were associated with diffuse nodal hyperplasia of the zona fasciculata in the cortex. The results suggest that there may be a LRHD variant running with excessive DOCS secretion and related to pathogenetically related to hyperplasia of predominantly the zone fasciculata in the adrenal cortex.
对10例原发性醛固酮增多症患者以及低肾素性高血压病(LRHD)的2个亚组进行了血浆醛固酮(A)和脱氧皮质酮(DOCS)水平测定:(1)肾上腺正常的患者(n = 11);(2)皮质有结构改变的患者(n = 11)。第1亚组患者的基础A和DOCS水平最低(分别为107.29±12.90和0.080±0.013 ng/ml),4小时步行刺激后这两种激素的浓度也较低(分别为211.57±30.47和0.095±0.024 ng/mg)。在第2亚组患者中,皮质的基础和步行后4小时的A和DOCS含量均升高(基础值分别为201.50±41.59和0.177±0.36 ng/mg,刺激后分别为331.33±30.47和0.302±0.061 ng/ml)。一些原发性醛固酮增多症患者在皮质存在结构改变时,对刺激的DOCS反应与LRHD患者相同。手术活检标本的组织学检查表明,较高的DOCS水平与皮质束状带弥漫性结节性增生有关。结果提示,可能存在一种LRHD变异型,伴有DOCS分泌过多,且与肾上腺皮质主要是束状带增生的发病机制相关。