肾上腺静脉采血在双侧肾上腺异常的原发性醛固酮增多症患者中的应用

摘要

Objective To explore the clinical value of adrenal venous sampling ( AVS ) in differential diagnosis of primary aldosteronism ( PA) with Bilateral abnormal adrenal glands .Methods Throughreviewing the related articles about AVS , and intergrating with one patient cured successfully in our hospital with the help of AVS, the CT scanning appeared bilateral adrenal masses .This patient had the following features:had more than ten years'hypertension , couldn't control the blood pressure well , and had resistant hypokalemia at the same time . Results AVS appeared that the patient also had a left -sided dominant hypersecretion of aldosterone .After left surgical resection of adrenal gland , the types of antihypertensive drugs were decreased from four to just only two , but the blood pressure , plasma potassium and aldosterone improved .The histopathological findings demonstrated adrenocorticaladenoma .Conclusions AVS plays a key role in choosing the next step treatment for the patients who have rarebilateral adrenal masses .%目的：探讨肾上腺静脉采血（ AVS）在鉴别诊断双侧肾上腺异常的原发性醛固酮增多症（ PA）中的临床意义。方法通过复习AVS相关文献，并结合我院运用AVS技术成功诊治肾上腺CT提示的双侧肾上腺占位PA患者1例。该例PA患者入院前有下列特点：高血压病史≥10年，血压控制欠佳，同时存在较顽固性低钾血症。结果 AVS结果示患者左侧存在明显优势分泌，行左侧肾上腺手术切除，术后病理证实为肾上腺皮质腺瘤，口服降压药物从术前的4种减至2种，血压、血钾、血醛固酮均恢复正常。结论对于罕见的双侧肾上腺占位的患者，AVS对下一步治疗方案的选择均起着十分重要的作用。