Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China.
Cancer Precision Diagnosis and Treatment and Translational Medicine Hubei Engineering Research Center, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China.
World J Urol. 2024 Jul 24;42(1):441. doi: 10.1007/s00345-024-05134-7.
To investigate the impact of adrenalectomy on hypertension in patients with nonfunctional adrenal tumors.
Between January 2020 and October 2022, patients with adrenal lesions were retrospectively screened for nonfunctional adrenal tumors at the Zhongnan Hospital of Wuhan University. All patients underwent detailed endocrinological examination and computed tomography to characterize the lesions. One year after discharge, follow-up blood pressure (BP) was assessed and compared to the blood pressure on admission. Univariate analysis and multivariate regression analysis were performed to determine factors predicting favorable hypertension outcomes after adrenalectomy.
A total of 309 patients were found to be eligible, including 123 who underwent adrenalectomy. Patients who underwent adrenalectomy were stratified into two groups: (Bancos I (2022) Adrenal Incidentalomas: Insights Into Prevalence. Ann Intern Med 175:1481-1482. https://doi.org/10.7326/M22-2600 ) those with improved hypertension (n = 71), and (Fassnacht M, Tsagarakis S, Terzolo M, Tabarin A, Sahdev A, Newell-Price J et al. (2023) European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol 189:G1-42. https://doi.org/10.1093/ejendo/lvad066 ) those without improved hypertension (n = 52). In contrast, the blood pressure levels of conservatively treated patients remained relatively stable 1 year after discharge. Univariate analysis and multivariate regression analysis showed that body mass index (BMI) and duration of hypertension were significantly different between the hypertension improvement group and the non-improvement group (p < 0.05).
Adrenalectomy has been shown to be effective in improving hypertension in certain patients with nonfunctional adrenal tumors. BMI and duration of hypertension were independent factors associated with favorable hypertension outcomes after adrenalectomy.
探讨肾上腺切除术对无功能性肾上腺肿瘤患者高血压的影响。
本研究回顾性筛选了 2020 年 1 月至 2022 年 10 月期间在武汉大学中南医院就诊的肾上腺病变患者，所有患者均行详细内分泌检查和 CT 以明确病变特征。出院后 1 年，评估并比较随访血压（BP）与入院时的血压。采用单因素分析和多因素回归分析确定预测肾上腺切除术后高血压良好结局的因素。
共筛选出 309 例符合条件的患者，其中 123 例行肾上腺切除术。将行肾上腺切除术的患者分为两组：（Bancos I（2022）Adrenal Incidentalomas：Insights Into Prevalence. Ann Intern Med 175：1481-1482. https://doi.org/10.7326/M22-2600）血压改善组（n=71）和血压未改善组（n=52）。相比之下，保守治疗患者的血压水平在出院后 1 年仍相对稳定。单因素分析和多因素回归分析显示，血压改善组和未改善组之间的体质指数（BMI）和高血压病程差异有统计学意义（p<0.05）。
肾上腺切除术可有效改善某些无功能性肾上腺肿瘤患者的高血压。BMI 和高血压病程是与肾上腺切除术后高血压良好结局相关的独立因素。
