原发性醛固酮增多症患者超选择性肾上腺动脉栓塞术临床疗效的对比研究

A Comparative Study of the Clinical Efficacy of Superselective Adrenal Artery Embolization for Patients with Primary Aldosteronism.

作者信息

Wang L, Xiang R, Chang J, Mao M, Feng R, Tao L, Tang P, Zhao Y P, Zuo Z, Gao D S, Pu P, Huang W, Li X, Chen J, Zhao H, Shi Q Y, Lv F J, He Y T, Khan N A, Xu Z X

机构信息

Department of Cardiovascular Medicine, Cadiovascular Research Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Am J Hypertens. 2025 Aug 14;38(9):666-674. doi: 10.1093/ajh/hpaf083.

DOI:10.1093/ajh/hpaf083

PMID:40372076

Abstract

BACKGROUND

Superselective adrenal artery embolization (SAAE) is a potential treatment option for patients with primary aldosteronism (PA).

METHODS

This retrospective study aimed to compare the clinical efficacy and impact on cardiorenal organs of SAAE with mineralocorticoid receptor antagonists (MRA) and adrenalectomy (ADX) in patients with PA. After a median follow-up of 19 (12.5-26.5) months, 148 patients with PA were included in the study. The study cohorts consisted of 58, 53, and 37 patients treated with SAAE, MRA, and ADX, respectively.

RESULTS

During follow-up, SAAE achieved a significantly greater level of complete clinical success in the treatment of PA compared to MRA (P < 0.05). Within the SAAE group (n = 58), 19 (32.8%) and 26 (44.8%) patients achieved complete and partial clinical success, respectively. However, there were no significant differences in the prognostic parameters of the cardiorenal organs between the two groups. In the comparison of patients with UPA treated with SAAE (n = 35) and ADX (n = 37), there was no significant difference in clinical efficacy between the two groups.

CONCLUSIONS

The findings of this study suggest that for patients with PA who are not suitable for ADX, SAAE is a viable treatment option that significantly improves clinical outcomes compared to MRA treatment.

摘要

背景

超选择性肾上腺动脉栓塞术（SAAE）是原发性醛固酮增多症（PA）患者的一种潜在治疗选择。

方法

本回顾性研究旨在比较SAAE与盐皮质激素受体拮抗剂（MRA）及肾上腺切除术（ADX）治疗PA患者的临床疗效及对心肾器官的影响。在中位随访19（12.5 - 26.5）个月后，148例PA患者纳入本研究。研究队列分别包括接受SAAE、MRA和ADX治疗的58例、53例和37例患者。

结果

随访期间，与MRA相比，SAAE在PA治疗中取得了显著更高的完全临床成功率（P < 0.05）。在SAAE组（n = 58）中，分别有19例（32.8%）和26例（44.8%）患者取得了完全和部分临床成功。然而，两组心肾器官的预后参数无显著差异。在比较接受SAAE治疗的单侧PA患者（n = 35）和ADX治疗的患者（n = 37）时，两组临床疗效无显著差异。