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目的:提高原发性醛固酮增多症(PAS)与嗜铬细胞瘤(PCM)的诊治水平。方法:手术治疗的住院患者76例:PAS组35例,PCM组41例。对患者一般资料、临床表现、血清生物化学及肿块病理性质等进行分析。结果:与PCM组比较,PAS组血清钾离子浓度显著降低(P<0.01),醛固酮浓度显著升高,瘤体较小,CT检出率较低;PCM组尿香草基杏仁酸浓度显著升高。PAS组腺瘤占80.0%,PCM组髓质嗜铬细胞瘤占85.4%。结论:血清钾离子浓度降低是诊断PAS最重要指标,检测尿香草基杏仁酸是诊断PCM的关键,CT和MRI检查可提高对PAS、PCM的诊断率;手术治疗是降低血压确实有效的治疗措施。
Objective: To improve the diagnosis and treatment of primary aldosteronism (PAS) and pheochromocytoma (PCM). Methods: Surgical treatment of 76 inpatients: PAS group 35 cases, PCM group 41 cases. General information on patients, clinical manifestations, serum biochemistry and pathological features of the mass were analyzed. Results: Compared with PCM group, serum potassium concentration in PAS group was significantly lower (P <0.01), aldosterone concentration was significantly higher, tumor size was smaller, and CT detection rate was lower. In PCM group, the concentration of kenate in urine was significantly increased . PAS group adenomas accounted for 80.0%, PCM group medulla pheochromocytoma accounted for 85.4%. Conclusions: The decrease of serum potassium concentration is the most important index in the diagnosis of PAS. Detecting urine vanilloid is the key to diagnose PCM. CT and MRI can improve the diagnosis rate of PAS and PCM. Surgical treatment is indeed a effective treatment for lowering blood pressure .