[1]赵振华胡卫列 郑东升赵国平 陈仕杰陈虎李岱赖建生.肾上腺增生性高血压单侧肾上腺切除术后高血压复发因素分析[J].中华腔镜泌尿外科杂志(电子版),2015,(02):91-95.[doi:10.3877/cma.j.issn.1674-3253.2015.02.003 ]
　Zhao Zhenhua,Hu Weilie,Zheng Dongsheng,et al.Influence factors for recurrent hypertension in patients with adrenal hyperplasia after unilateral adrenalectomy[J].,2015,(02):91-95.[doi:10.3877/cma.j.issn.1674-3253.2015.02.003 ]
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肾上腺增生性高血压单侧肾上腺切除术后高血压复发因素分析()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2015年02期
页码:
91-95
栏目:
临床研究
出版日期:
2015-08-31

文章信息/Info

Title:
Influence factors for recurrent hypertension in patients with adrenal hyperplasia after unilateral adrenalectomy
作者:
赵振华1胡卫列 2郑东升1赵国平 1陈仕杰1陈虎1李岱1赖建生 1
529000 江门，南方医科大学附属江门医院泌尿外科1；510000 广州，广州军区广州总医院泌尿外科2
Author(s):
Zhao Zhenhua1;  Hu Weilie2;  Zheng Dongsheng1;  Zhao Guoping1;  Chen Shijie1;  Chen Hu1;  Li Dai1;  Lai Jiansheng1.
Department of Urology, Jiangmen hospital Affiliated to Southern Medical University,Jiangmen 529000, China; 2Department of Urology, Guangzhou general hospital of Guangzhou command, Guangzhou 510000, China
关键词:
肾上腺增生; 肾上腺切除术; 继发性高血压; 复发
DOI:
10.3877/cma.j.issn.1674-3253.2015.02.003
摘要:
目的探讨肾上腺增生性高血压单侧肾上腺切除术后高血压复发的影响因素。方法回顾性分析南方医科大学附属江门医院自 2004年 1月至 2012年 2月期间 68例接受单侧肾上腺切除手术治疗的单侧肾上腺增生高血压患者的临床资料。对患者的一般资料进行收集整理，对患者术后血压、症状进行随访。统计分析肾上腺增生性高血压单侧肾上腺切除术后高血压复发的影响因素。结果 68例单侧肾上腺增生性高血压患者行患侧肾上腺切除，术后血压正常。在 6个月后的随访中（随访时间 47.2±5.9个月），有 25例（ 36.8%）患者血压再次升高或再次需要口服药物控制血压。在影响手术疗效变量的单因素分析中，年龄、术后收缩压水平、高血压病程、肾上腺增生类型有统计学意义（P<0.05）。在对以年龄、性别、体重指数、手术侧别、高血压病程、肾上腺增生类型、术前血钾、术后收缩压水平、皮质醇节律、血浆醛固酮肾素比、尿儿茶酚胺代谢物水平等作为自变量的多因素 Logistic回归分析中，影响术后高血压复发的因素有年龄 >50岁，高血压病程 >5年，肾上腺增生类型为皮髓质增生。结论单侧肾上腺切除对于治疗肾上腺增生性高血压是安全、有效的。术后影响高血压复发的主要因素有高龄（年龄 >50岁）、长病程（ >5年）、皮髓质增生类型，可为肾上腺增生性高血压患者手术预后评

参考文献/References:

[1] Milliez P, Girerd X, Plouin PF, et al. Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism[J]. J Am Coll Cardiol, 2005, 45(8): 1243-1248. [2] Viola A, Tizzani D, Monticone S, et al. Diagnosis and treatment of unilateral forms of primary aldosteronism[J]. Curr Hypertens Rev, 2013, 9(2): 156-165. [3] Ito K, Yoshii T, Shinmoto H, et al. Laparoscopic enucleation of macronodules in a patient with ACTH-independent macronodular adrenal hyperplasia 7 years after unilateral adrenalectomy: consideration of operative procedure [J]. Urol Int, 2013, 90 (3): 253-258. [4] Lin YH, Lin LY, Chen A, et al. Adrenalectomy improves increased carotid intima-media thickness and arterial stiffness in patients with aldosterone producing adenoma [J]. Atherosclerosis, 2012, 221(1): 154-159. [5] Hennings J, Andreasson S, Botling J, et al. Long-term effects of surgical correction of adrenal hyperplasia and adenoma causing primary aldosteronism [J]. Langenbecks Arch Surg,2010,395(2): 133-137. [6] Jiang SB, Guo XD, Wang HB, et al. A retrospective study of laparoscopic unilateral adrenalectomy for primary hyperaldosteronism caused by unilateral adrenal hyperplasia [J]. Int Urol Nephrol, 2014, 46(7): 1283-1288. [7] Iacobone M, Albiger N, Scaroni C, et al. The role of unilateral adrenalectomy in ACTH-independent macronodular adrenal hyperplasia (AIMAH)[J]. World J Surg, 2008, 32(5): 882-889. [8]华伟 ,胡卫列 ,汪帮琦 ,等.年龄因素对外科治疗肾上腺增生性高血压疗效的影响[J].中国全科医学 , 2010, 13(12): 1338-1339. [9] Gockel I, Heintz A, Polta M, et al. Long-term results of endoscopic adrenalectomy for Conn's syndrome[J]. Am Surg, 2007, 73(2): 174-180. [10] Rossi GP, Bernini G, Desideri G, et al. Renal damage in primary aldosteronism: results of the PAPY Study[J]. Hypertension, 2006, 48(2): 232-238. [11] Douma S, Petidis K, Doumas MA, et al. Prevalence of primary hyperaldosteronism in resistant hypertension: a retrospective observational study[J]. Lancet, 2008, 371(9628): 1921-1926. [12] Wang W, Hu WL, Zhang XM, et al. Predictors of successful outcome after adrenalectomy for primary aldosteronism[J]. Int Surg, 2012, 97(2): 104-111. [13] Singh M, Mandal S, Kakkar A K, et al. Mixed corticomedullary tumour with myelolipoma: a rare coexistence [J]. Pathology, 2010,42(6):589-591. [14] Donatini G, Van SS, Aubert S, et al. Corticomedullary mixed tumor of the adrenal gland-a clinical and pathological chameleon: case report and review of literature[J]. Updates Surg, 2013, 65(2): 161-164. [15]胡卫列，吕军，聂海波，等.肾上腺皮质髓质混合性病变的诊治研究[J].临床泌尿外科杂志, 2009, 24(4): 285-287.

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备注/Memo

备注/Memo:
基金项目：广东省江门市科技计划项目（江科[2014]72 号）
通讯作者：胡卫列，Email：huwl-mr@vip.sina.com
更新日期/Last Update: 1900-01-01