论文部分内容阅读
【目的】探讨继发性高血压与垂体微腺瘤的联系及垂体微腺瘤的核磁共振成像(MRI)诊断价值。【方法】分析比较21例高血压伴垂体微腺瘤患者的临床、实验室检查和影像学资料。【结果】21例患者的主要表现:(1)发病年龄较轻,均有头痛症状;(2)24 h动态血压监测(24 h ABPM)显示血压昼夜节律消失,收缩压/舒张压明显增高;(3)服用降压药降压效果不明显;(4)腺垂体激素中,促肾上腺皮质激素(ACTH)大多数病例超过正常值,少数病例的泌乳素(PRL)超过正常值,其余激素正常;(5)部分病例MRI提示肾上腺皮质增生、肾上腺腺瘤、嗜铬细胞瘤;(6)全部病例MRI提示垂体微腺瘤。【结论】对于药物降压效果不佳的高血压中青年患者,应常规进行肾上腺、特别是垂体MRI检查,而MRI是诊断垂体微腺瘤的最佳影像学方法,对中医辨证论治也具有重要的参考价值。
【Objective】 To investigate the relationship between secondary hypertension and pituitary adenoma and the diagnostic value of magnetic resonance imaging (MRI) of pituitary adenoma. 【Methods】 The clinical data, laboratory findings and imaging data of 21 patients with hypertensive pituitary adenoma were compared and analyzed. 【Results】 The main manifestations of 21 patients were: (1) younger age with headache; (2) 24h ambulatory blood pressure monitoring (24 h ABPM) showed disappearance of circadian rhythm of blood pressure and systolic / diastolic pressure increased significantly; (3) The antihypertensive effect of taking antihypertensive drugs was not obvious; (4) The majority of ACTH in pituitary gland hormones exceeded the normal value. In a few cases, the prolactin (PRL) exceeded the normal value and the rest hormone was normal ; (5) MRI showed some cases of adrenal hyperplasia, adrenal adenomas, pheochromocytoma; (6) all cases of MRI prompted pituitary adenoma. 【Conclusion】 MRI examination of the adrenal gland, especially the pituitary gland, should be routinely performed in young and middle-aged hypertensive patients with poor antihypertensive effects of drugs. MRI is the best imaging method for diagnosis of pituitary adenoma and is also important for syndrome differentiation and treatment of pituitary. Reference value.