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目的:研究高血压人群中发现的肾上腺醛固酮瘤切除手术前安体舒通治疗围手术期降压的临床疗效。方法:回顾34例肾上腺醛固酮瘤临床资料,分析术前安体舒通试验性治疗效果围手术期血压变化。结果:安体舒通治疗有效组(18例)比无效组(16例)围手术期收缩压和舒张压都显著下降[收缩压:(125.7±7.0)mmHgvs(140.9±15.6)mmHg,舒张压:(75.8±7.0)mmHgvs(86.2±8.9)mmHg,P<0.01]。与安体舒通试验性治疗前的血压相比,安体舒通治疗有效组围手术期收缩压和舒张压都显著下降[收缩压:(144.7±7.5)mmHgvs(125.7±7.0)mmHg,P<0.01,舒张压:(93.6±6.9)mmHgvs(75.8±7.0)mmHg,P<0.01],而无效组则均无统计学差异[收缩压:(144.6±11.3)mmHgvs(140.9±15.6)mmHg,(91.2±10.4)mmHgvs(86.2±8.9)mmHg,P<0.05]。将围手术期血压变化与安体舒通治疗效果进行偏相关分析,控制所有与安体舒通治疗相关和影响围手术期血压的因素,安体舒通试验治疗收缩压和舒张压改变分别与围手术期血压改善呈正相关(r=0.434,P=0.03;r=0.716,P=0.001)。结论:在高血压人群中筛选的肾上腺醛固酮瘤,术前安体舒通治疗(抗醛固酮治疗)的有效性与围手术期血压改善呈正相关。
OBJECTIVE: To study the clinical efficacy of anti-hypertension in the treatment of adrenal aldosteroneoma found before the surgical removal of adrenal hypertensive subjects. Methods: The clinical data of 34 cases of adrenal aldosteronoma were retrospectively reviewed. The preoperative blood pressure changes during the perioperative period were tested. Results: The systolic blood pressure and diastolic blood pressure were significantly decreased in perioperative sphincter-pressure group (18 cases) (18 cases) and (140.9 +/- 15.6) mmHg cases of diastolic blood pressure. : (75.8 ± 7.0) mmHgvs (86.2 ± 8.9) mmHg, P <0.01]. Compared with the blood pressure before the trial treatment of Spironolactone, the systolic blood pressure and the diastolic blood pressure decreased significantly during the perioperative period in the active care-study group [SBP: (144.7±7.5) mmHgvs (125.7±7.0) mmHg,P <0.01, diastolic blood pressure: (93.6 ± 6.9) mmHgvs (75.8 ± 7.0) mmHg, P <0.01], while there was no statistical difference in the ineffective group [systolic pressure: (144.6 ± 11.3) mmHgvs (140.9 ± 15.6) mmHg, (91.2 ± 10.4) mmHgvs (86.2 ± 8.9) mmHg, P <0.05]. The perioperative blood pressure changes were compared with the results of the treatment of spironolactone to control all the factors related to the treatment of spironolactone and affect the perioperative blood pressure. The Spironolactone test treated systolic and diastolic blood pressure changes respectively. Perioperative blood pressure improvement was positively correlated (r=0.434, P=0.03; r=0.716, P=0.001). Conclusion: The screening for adrenal aldosteronoma in hypertensive subjects was positively correlated with the efficacy of preoperative anti-tuberculosis therapy (antialdosterone therapy) and improvement of perioperative blood pressure.