引用本文:钟钻仪,黄淑玲,周宇清,张慧芬,吴倩莹.血钾正常的原发性醛固酮增多症患者临床特点分析[J].中国临床新医学,2018,11(9):906-909.
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血钾正常的原发性醛固酮增多症患者临床特点分析
钟钻仪,黄淑玲,周宇清,张慧芬,吴倩莹
523003 广东,东莞市中医院内分泌科
摘要:
[摘要] 目的 分析血钾正常的原发性醛固酮增多症患者的临床特点。方法 选择2013-01~2016-12在东莞市中医院确诊的140例原发性醛固酮增多症患者,将其分为低血钾组60例和正常血钾组80例,回顾性分析其临床、生化及影像学资料。结果 低血钾组以1级高血压和2级高血压多见,而正常血钾组以2级高血压和3级高血压多见(P<0.05)。低血钾组血钠[(149.79±4.23)mmol/L]高于正常血钾组[(140.23±2.86)mmol/L],差异有统计学意义(P<0.05),而低血钾组血钾[(2.97±0.2)mmol/L]低于正常血钾组[(3.92±0.3)mmol/L],差异有统计学意义(P<0.05)。两组患者的坐位肾素活性、坐位醛固酮水平比较差异统计学意义(P>0.05)。低血钾组中醛固酮瘤多见,而正常血钾组中特发性醛固酮增多症更为多见,两组患者的肾上腺病变差异有统计学意义(P<0.05)。两组患者的左心室肥厚、颈动脉斑块、慢性肾功能不全、脑梗死等靶器官损伤情况比较差异统计学意义(P>0.05)。结论 血钾正常的原发性醛固酮增多症患者临床表现不一,主要表现为中、重度高血压,其分型以特发性醛固酮增多症为主。
关键词:  原发性醛固酮增多症  血钾  醛固酮/肾素活性比值
DOI:10.3969/j.issn.1674-3806.2018.09.16
分类号:R 586.2+4
基金项目:
Analysis of clinical characteristics of primary aldosteronism patients with normal serum potassium
ZHONG Zuan-yi, HUANG Shu-ling, ZHOU Yu-qing, et al.
Department of Endocrinology, Dongguan Hospital of Traditional Chinese Medicine, Guangdong 523003, China
Abstract:
[Abstract] Objective To investigate the clinical characteristics of primary aldosteronism patients with normal serum potassium. Methods From January 2013 to December 2016, the patients with primary aldosteronism in Dongguan Hospital of Traditional Chinese Medicine were divided into hypokalemia group(60 cases) and normal potassium group(80 cases). The clinical, biochemical and imaging data were retrospectively analyzed. Results  Grade1 and grade 2 hypertension were more common in the hypokalemia group, while grade 2 and grade 3 were more common in the normal blood potassium group(P<0.05). The serum sodium in the hypokalemia group [(149.79±4.23)mmol/L] was higher than that in the normal blood potassium group [(140.23±2.86)mmol/L](P<0.05), while the blood potassium in the low potassium group [(2.97±0.2)mmol/L] was lower than that in the normal potassium group [(3.92±0.3)mmol/L](P<0.05). There were no significant differences in the sitting renin activity and the level of the sitting aldosterone between the two groups(P>0.05). Aldosterone producing tumors was more common in the hypokalemia group, while idiopathic hyperaldosteronism was more common in the normal potassium group. There were significant differences in adrenal lesions between the two groups(P<0.05). There were no significant differences in the damage of target organs such as left ventricular hypertrophy, carotid plaque, chronic renal insufficiency and cerebral infarction between the two groups(P>0.05). Conclusion The clinical manifestations of primary aldehyde patients with normal serum potassium are various, mainly characterized by moderate and severe hypertension, and idiopathic hyperaldosteronism is their main classification type.
Key words:  Primary aldosteronism  Serum potassium  Aldosterone to rennin activity ratio