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目的分析原发性醛固酮增多症(PA)的临床表现、辅助检查、治疗及术后血压变化。方法对1999-01-2009-07间连续确诊的108例PA患者的临床资料进行回顾性分析。结果 91.7%患者有高血压,低血钾者占89.8%,57.8%出现高血压的心脏并发症;卧位醛固酮与肾素活性比值(ARR)>25者占87%。行手术治疗的患者中,38.5%仍有高血压,回归分析显示术后血压与高血压家族史独立相关(RR=9.00,95%CI1.268～63.892,P=0.028)。结论高血压伴低血钾是PA的重要临床表现,卧位ARR>25是PA重要的筛选标准,有高血压家族史患者PA手术后易出现高血压。
Objective To analyze the clinical manifestations of primary aldosteronism (PA), assist in the examination, treatment and postoperative blood pressure changes. Methods The clinical data of 108 consecutive PA patients diagnosed between January 1999 and July 2009 were analyzed retrospectively. Results 91.7% of the patients had hypertension, hypokalemia accounted for 89.8%, 57.8% had cardiac complications of hypertension, and those with ARR> 25 were 87%. Among the patients undergoing surgical treatment, 38.5% still had hypertension. Regression analysis showed that postoperative blood pressure was independently associated with family history of hypertension (RR = 9.00, 95% CI 1.268-63.892, P = 0.028). Conclusions Hypertension with hypokalemia is an important clinical manifestation of PA. ARR> 25 in lying position is an important screening criteria for PA. Hypertension is more likely to occur after PA in patients with family history of hypertension.