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为了解产生醛固酮的肾上腺腺瘤（ＡＰＡ）术后部分患者持续高血压的病因，作者对５３例产生醛固酮的肾上腺腺瘤术后患者进行了平均３．１年的随访。全部患者术后血钾正常，血压正常者３７例，血压≥１８．７／１２．７ｋＰａ１６例。将正常血压与持续高血压２组患者从性别、年龄、有无高血压史，对安体舒通的降压反应、术前高血压值、高血压时间、血清钾值、２４小时尿醛固酮值、ＰＲＡ值以及手术方式进行比较。结果显示：≥５０岁ＡＰＡ患者发生持续高血压机会与＜４０岁ＡＰＡ患者比值比３∶１；在持续高血压的平均年龄与正常血压平均年龄以及对安体舒通的降压反应之间存在显著差异（Ｐ＜０．０５）。提示年龄愈大的ＡＰＡ患者以及对安体舒通降压反应不明显的患者除了醛固酮增高引起高血压的原因之外，尚有肾内小血管病变或肾间质病变等原因。作者建议对该类患者手术时行肾穿刺活检，以明确病因，有利术后进一步治疗。
To understand the causes of persistent hypertension in some patients who developed aldosterone adenomas (APA) after surgery, the authors performed an average of 3.1 years of follow-up for 53 patients who developed aldosterone-induced adrenal adenomas. All patients had normal postoperative potassium levels, 37 patients with normal blood pressure, and 16 patients with blood pressure ≥ 18.7/12.7 kPa. Patients with normal blood pressure and persistent hypertension from the gender, age, history of hypertension, antihypertensive response to spironolactone, preoperative hypertension, hypertension time, serum potassium, 24-hour urinary aldosterone Comparison of PRA values and surgical methods. The results showed that the chance of sustained hypertension occurred in patients with APA≥50 years old and the ratio of patients with APA<40 years old was 3:1; there existed between the average age of persistent hypertension and the average age of normotensive patients and the antihypertensive response to antipsychotics. Significant difference (P<0.05). It is suggested that in patients with APA who are older, and those who do not have a significant antihypertensive response to spironolactone, in addition to the causes of hypertension caused by increased aldosterone, there are other causes such as renal small-vessel disease or renal interstitial lesions. The authors recommend renal biopsy for this type of patient during surgery in order to clarify the cause and facilitate postoperative further treatment.