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目的提高醛固酮瘤的诊治水平。方法回顾性分析郑州大学第一附属医院1986—2005年所有病理诊断为醛固酮瘤的260例患者的临床资料。结果左侧肾上腺腺瘤132例,右侧119例,双侧5例,多发腺瘤4例。260例患者均有高血压症状。生化检查中,低血钾206例,糖耐量减低26例。血浆肾素、血管紧张素、醛固酮测定中,207例高醛固酮伴低肾素,19例高醛固酮伴高肾素。182例患者行体位激发试验,93例患者直立位时醛固酮水平较卧位时降低,89例醛固酮升高。260例患者均经手术治疗。术后血压恢复正常236例,其余24例患者血压较术前下降。结论完善检查手段可提高醛固酮瘤的检出率,确诊需病理检查,手术是根本的治疗方法。
Objective To improve the diagnosis and treatment of aldosterone tumors. Methods The clinical data of 260 patients with aldosteronoma diagnosed by pathology in the First Affiliated Hospital of Zhengzhou University from 1986 to 2005 were retrospectively analyzed. Results The left adrenal adenoma 132 cases, 119 cases of right, bilateral in 5 cases, multiple adenomas in 4 cases. All 260 patients had symptoms of hypertension. Biochemical tests, 206 cases of hypokalemia, impaired glucose tolerance in 26 cases. Plasma renin, angiotensin and aldosterone were measured in 207 patients with high aldosterone and low renin and 19 with high aldosterone and high renin. In 182 patients, the level of aldosteronism was decreased in the upright position and the level of aldosterone in 89 patients was increased. 260 patients were surgically treated. Postoperative blood pressure returned to normal in 236 cases, the remaining 24 patients with decreased blood pressure compared with preoperative. Conclusion Improve the detection methods can increase the detection rate of aldosterone tumors, diagnosis required pathological examination, surgery is the fundamental treatment.