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目的 探讨影响肾上腺皮质醛固酮瘤 (APA)术后血压恢复的相关因素。方法 对 6 8例APA患者眼底视网膜血管彩色超声 ,尿微量蛋白、肾穿刺病理及APA腺瘤周围肾上腺组织不同病理变化与术后持续高血压之间的关系进行分析。结果 34例单侧或双侧视网膜中央动脉阻力增高的APA患者术后持续高血压 14例 (41 2 % ) ,2 4例尿微量蛋白增高者术后持续高血压 16例 (6 6 7% )。行肾穿刺活检的 15例患者均显示肾脏有不同性质、不同程度的病理变化 ,其中术后持续高血压者 11例 (73 3% )。病理学检查显示 ,APA腺瘤周肾上腺萎缩者 4 5例 ,其中术后持续高血压者 10例(2 2 2 % ) ;2 0例APA腺瘤周肾上腺正常和增生者 2 0例 ,其中术后持续高血压者 8例 (40 % )。结论 肾脏病理变化和视网膜中央动脉阻力增加与APA术后血压不能恢复正常密切相关。
Objective To investigate the related factors that influence the recovery of blood pressure after adrenal aldosteronoma (APA). Methods The relationship between retinal vascular color ultrasonography, microalbuminuria, renal biopsy and the pathological changes of adrenal tissue around APA adenocarcinoma and persistent hypertension after operation were analyzed in 68 APA patients. Results Thirty-four APA patients with unilateral or bilateral central retinal artery resistance increased persistent hypertension (41.2%), 24 cases of elevated urinary microalbuminuria sustained postoperative hypertension (16.6%), . Fifteen patients undergoing renal biopsy showed different pathological changes of kidney in different degree, of which 11 cases (73.3%) had postoperative persistent hypertension. Pathological examination showed 45 cases of APA adenocarcinoma with adrenal gland atrophy, of which 10 cases (22.2%) had persistent postoperative hypertension; 20 cases of 20 cases of normal and hyperplastic APA adenoma After persistent hypertension in 8 cases (40%). Conclusion The pathological changes of kidney and central retinal artery resistance are closely related to the abnormal blood pressure after APA.