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目的:探讨原发性醛固酮增多症(PA)的临床特征。方法:报告 236 例 PA患者的临床资料。结果:236例PA患者中,137例出现低血钾、肌无力及麻痹,重者伴呼吸肌麻痹;144 例高血压,其中半数并发肌无力及麻痹;146例夜尿增多。盐负荷试验血醛固酮增高,尿醛固酮高于 38.8 nmol/24 h。B超的阳性率为63.3%,CT为 96.5%,MRI为 81.2%。体位试验:醛固酮瘤患者血浆醛固酮水平无显著变化。结论:高血压、低血钾、高醛固酮血症是PA的典型临床表现,盐负荷试验、体位试验和影像学检查有助于确诊。手术切除肿瘤是其主要治疗手段,腹腔镜手术正成为其首选术式。
Objective: To investigate the clinical features of primary aldosteronism (PA). Methods: The clinical data of 236 patients with PA were reported. Results: Of the 236 patients with PA, 137 developed hypokalemia, muscle weakness and paralysis, with severe respiratory distress syndrome; 144 patients with hypertension, half of which developed muscle weakness and paralysis; 146 patients had nocturia. Salt stress test elevated serum aldosterone, urinary aldosterone higher than 38.8 nmol / 24 h. The positive rate of B ultrasound was 63.3%, CT was 96.5% and MRI was 81.2%. Postural test: There was no significant change in plasma aldosterone levels in patients with aldosterone. Conclusion: Hypertension, hypokalemia and hyperaldosteronism are the typical clinical manifestations of PA. Salt stress test, postural test and imaging examination are helpful to confirm the diagnosis. Surgical removal of the tumor is its main treatment, laparoscopic surgery is becoming the preferred surgical approach.