Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Munich, Germany.
Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy.
Eur J Endocrinol. 2018 Jul;179(1):R19-R29. doi: 10.1530/EJE-17-0990. Epub 2018 Apr 19.
The syndrome of primary aldosteronism (PA) is characterized by hypertension with excessive, autonomous aldosterone production and is usually caused by either a unilateral aldosterone-producing adenoma or bilateral adrenal hyperplasia. The diagnostic workup of PA is a sequence of three phases comprising screening tests, confirmatory tests and the differentiation of unilateral from bilateral forms. The latter step is necessary to determine the optimal treatment approach of unilateral laparoscopic adrenalectomy (for patients with unilateral PA) or medical treatment with a mineralocorticoid receptor antagonist (for patients with bilateral PA). Since the publication of the revised Endocrine Society guideline 2016, a number of key studies have been published. They challenge the recommendations of the guideline in some areas and confirm current practice in others. Herein, we present the recent developments and current approaches to the medical management of PA.
原醛症（PA）的综合征特征为高血压伴过量自主醛固酮分泌，通常由单侧醛固酮瘤或双侧肾上腺增生引起。PA 的诊断过程是一个由三个阶段组成的序列，包括筛查试验、确认试验以及单侧和双侧形式的区分。后一步对于确定单侧腹腔镜肾上腺切除术（单侧 PA 患者）或使用盐皮质激素受体拮抗剂进行药物治疗（双侧 PA 患者）的最佳治疗方法是必要的。自 2016 年内分泌学会修订指南发布以来，已经发表了许多关键研究。它们在某些领域挑战了指南的建议，而在其他领域则证实了当前的实践。在此，我们介绍 PA 的医学治疗的最新进展和当前方法。
