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目的:探讨原发性醛固酮增多症（PA）的诊断和治疗方法。方法:对1988年～2001年间收治的PA46例进行分析。所有患者均行血醛固酮测定、安体舒通试验及B超、CT检查。40例行肾上腺肿瘤切除术,6例行肿瘤切除术及同侧肾上腺部分切除术。结果:肾上腺皮质腺瘤45例,肾上腺皮质增生1例。46例血钾均低于正常,42例血醛固酮增高,46例安体舒通试验均阳性,B超、CT定位检查,其准确率分别为84.8％、95.6％。46例患者血钾均恢复正常。44例肾上腺腺瘤治愈,1例腺瘤及1例肾上腺皮质增生仍需药物控制血压。结论:安体舒通试验、血醛固酮测定是PA的主要定性诊断方法,血醛固酮体位试验和影像学检查有助于肾上腺皮质腺瘤和增生的鉴别;PA的定位主要依靠B超、CT检查。外科手术是治疗PA的重要方法。
Objective: To investigate the diagnosis and treatment of primary aldosteronism (PA). Methods: A total of 46 PA patients treated between 1988 and 2001 were analyzed. All patients underwent aldosteronism, spironolactone test and B-ultrasound, CT examination. 40 cases of adrenalectomy, 6 cases of tumor resection and ipsilateral adrenalectomy. Results: There were 45 cases of adrenocortical adenoma and 1 case of adrenal hyperplasia. 46 cases of serum potassium were lower than normal, 42 cases of serum aldosteronism increased, 46 cases of spironolactone were positive, B-ultrasound and CT mapping, the accuracy rates were 84.8%, 95.6%. 46 patients with serum potassium returned to normal. 44 cases of adrenal adenoma cured, 1 case of adenoma and 1 case of adrenal hyperplasia still need medication to control blood pressure. Conclusions: Spironolactone test, serum aldosteron test is the main qualitative diagnostic method of PA, serum aldosterone position test and imaging findings contribute to the identification of adrenal cortical adenoma and hyperplasia; PA mainly rely on B-ultrasound, CT examination. Surgery is an important method of treatment of PA.