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导致动脉高血压的内分泌肿瘤:病理生理机制及临床意义

Endocrine Tumors Causing Arterial Hypertension: Pathophysiological Mechanisms and Clinical Implications.

作者信息

Buonacera Agata, Stancanelli Benedetta, Malatino Lorenzo

机构信息

From the Academic Unit of Internal Medicine and Hypertension Centre, Department of Clinical and Experimental Medicine, University of Catania, c/o Cannizzaro Hospital, Via Messina 829, 95126, Catania, Italy.

出版信息

High Blood Press Cardiovasc Prev. 2017 Sep;24(3):217-229. doi: 10.1007/s40292-017-0200-9. Epub 2017 Apr 12.

Abstract

Some tumors are a relatively rare and amendable cause of hypertension, often associated with a higher cardiovascular morbidity and mortality, as compared with that of both general population and patients with essential hypertension. This worse prognosis is not entirely related to blood pressure increase, because the release of substances from the tumor can directly influence blood pressure behavior. Diagnostic approach is challenging and needs a deep knowledge of the different neuro-hormonal and genetic mechanisms determining blood pressure increase. Surgical tumor removal can, but not always, cause blood pressure normalization, depending on how early was tumor detection, since a long-standing history of hypertension is often associated with a much weaker effect on blood pressure. Moreover, target organ damage can be affected by the substances themselves released by the tumors as well as by tumor removal. In this review we consider the phenotype and genetic features of patients with tumor-induced hypertension and focus on their diagnostic work-up.

摘要

一些肿瘤是导致高血压的相对罕见且可治疗的病因,与普通人群和原发性高血压患者相比,通常伴有更高的心血管发病率和死亡率。这种较差的预后并不完全与血压升高有关,因为肿瘤释放的物质可直接影响血压变化。诊断方法具有挑战性,需要深入了解决定血压升高的不同神经激素和遗传机制。手术切除肿瘤可能(但并非总是)使血压恢复正常,这取决于肿瘤检测的时间早晚,因为长期高血压病史往往对血压的影响较弱。此外,肿瘤释放的物质以及肿瘤切除都会影响靶器官损伤。在本综述中,我们考虑肿瘤性高血压患者的表型和遗传特征,并重点关注其诊断检查。

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