Bianda T, Schmid C
Abteilung Endokrinologie und Diabetologie, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1998 Aug 29;128(35):1277-83.
Primary aldosteronism is a rare cause of hypertension caused by increased aldosterone secretion. The two essential stimuli for aldosterone production, potassium and angiotensin II, tend to be low. At a time when imaging procedures are becoming more common, more patients are being found with adrenal masses, and patients with incidentalomas and low renin hypertension could be considered as candidates for surgery. Apart from an appropriate work-up for the diagnosis of primary aldosteronism, the differential diagnosis between unilateral adenoma and idiopathic ("hyperplasia") hyperaldosteronism is relevant for the choice of therapy. Based on data from the literature and four patients we observed as outpatients in 1997, we suggest that a properly conducted and carefully interpreted postural stimulation test can be useful in identifying patients who are successfully treated by drugs.
原发性醛固酮增多症是一种由醛固酮分泌增加引起的罕见高血压病因。醛固酮产生的两个主要刺激因素，即钾和血管紧张素II，往往较低。在影像学检查越来越普遍的时代，发现肾上腺肿块的患者越来越多，偶发瘤和低肾素性高血压患者可被视为手术候选者。除了对原发性醛固酮增多症进行适当的诊断检查外，单侧腺瘤与特发性（“增生性”）醛固酮增多症之间的鉴别诊断对于治疗方案的选择至关重要。根据文献数据以及我们在1997年门诊观察的4例患者，我们认为正确进行并仔细解读的体位刺激试验有助于识别那些药物治疗有效的患者。
