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内分泌性高血压:当前病因发病机制及治疗选择概述

Endocrine hypertension: An overview on the current etiopathogenesis and management options.

作者信息

Thomas Reena M, Ruel Ewa, Shantavasinkul Prapimporn Ch, Corsino Leonor

机构信息

Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University Medical Center, Durham, NC 27710, United States.

Division of Nutrition and Biochemical Medicine, Department of Medicine, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok 10400, Thailand.

出版信息

World J Hypertens. 2015;5(2):14-27. doi: 10.5494/wjh.v5.i2.14.

Abstract

Endocrine causes of secondary hypertension include primary aldosteronism, pheochromocytoma, cushing's syndrome, hyperparathyroidism and hypo- and hyperthyroidism. They comprise of the 5%-10% of the causes of secondary hypertension. Primary hyperaldosteronism, the most common of the endocrine cause of hypertension often presents with resistant or difficult to control hypertension associated with either normo-or hypokalemia. Pheochromocytoma, the great mimicker of many conditions, is associated with high morbidity and mortality if left untreated. A complete history including pertinent family history, physical examination along with a high index of suspicion with focused biochemical and radiological evaluation is important to diagnose and effectively treat these conditions. The cost effective targeted genetic screening for current known mutations associated with pheochromocytoma are important for early diagnosis and management in family members. The current review focuses on the most recent evidence regarding causes, clinical features, methods of diagnosis, and management of these conditions. A multidisciplinary approach involving internists, endocrinologists and surgeons is recommended in optimal management of these conditions.

摘要

继发性高血压的内分泌病因包括原发性醛固酮增多症、嗜铬细胞瘤、库欣综合征、甲状旁腺功能亢进以及甲状腺功能减退和亢进。它们占继发性高血压病因的5% - 10%。原发性醛固酮增多症是高血压最常见的内分泌病因,常表现为难治性或难以控制的高血压,伴有正常血钾或低钾血症。嗜铬细胞瘤能模仿多种病症,如果不治疗,其发病率和死亡率都很高。完整的病史,包括相关家族史、体格检查,以及高度的怀疑指数并辅以针对性的生化和影像学评估,对于诊断和有效治疗这些病症很重要。针对目前已知与嗜铬细胞瘤相关突变进行具有成本效益的靶向基因筛查,对于家庭成员的早期诊断和管理很重要。本综述聚焦于有关这些病症的病因、临床特征、诊断方法及管理的最新证据。在这些病症的最佳管理中,建议采用由内科医生、内分泌科医生和外科医生组成的多学科方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9abb/4582789/88fefafe2718/nihms678078f1.jpg

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