Loh Wann Jia, Lim Dawn Shao Ting, Loh Lih Ming, Kek Peng Chin
Department of Endocrinology, Changi General Hospital, SingHealth, Singapore.
Department of Endocrinology, Singapore General Hospital, SingHealth, Singapore.
Endocrinol Metab (Seoul). 2018 Sep;33(3):355-363. doi: 10.3803/EnM.2018.33.3.355. Epub 2018 Aug 14.
The aim of this study was to investigate the factors associated with resolution of hypertension after adrenalectomy in patients with primary aldosteronism. A secondary aim was to describe our use of the contralateral ratio in adrenal venous sampling (AVS) in the setting of suboptimal successful cannulation rates.
A retrospective review of patients who underwent AVS followed by unilateral adrenalectomy for primary aldosteronism was performed.
Complete resolution of hypertension and hypokalemia was seen in 17 of 40 patients (42.5%), while a clinical improvement in hypertension was seen in 38 of 40 (95%). Shorter duration of hypertension, mean aldosteronoma resolution score (ARS), and a high ARS of 3 to 5 were associated with resolution of hypertension after adrenalectomy (=0.02, =0.02, and =0.004, respectively). Of the individual components of ARS, only a duration of hypertension of ≤6 years was associated with resolution of hypertension after adrenalectomy (=0.03).
A shorter duration of hypertension was significantly associated with resolution of hypertension after adrenalectomy in patients with primary aldosteronism.
本研究旨在调查原发性醛固酮增多症患者肾上腺切除术后高血压缓解的相关因素。次要目的是描述在插管成功率不理想的情况下，我们在肾上腺静脉采血（AVS）中对侧比值的应用情况。
对接受AVS并随后因原发性醛固酮增多症行单侧肾上腺切除术的患者进行回顾性研究。
40例患者中有17例（42.5%）高血压和低钾血症完全缓解，40例中有38例（95%）高血压有临床改善。高血压病程较短、平均醛固酮瘤缓解评分（ARS）以及ARS为3至5分与肾上腺切除术后高血压缓解相关（分别为P=0.02、P=0.02和P=0.004）。在ARS的各个组成部分中，只有高血压病程≤6年与肾上腺切除术后高血压缓解相关（P=0.03）。
原发性醛固酮增多症患者肾上腺切除术后，较短的高血压病程与高血压缓解显著相关。
