The diagnosis and treatment of primary aldosteronism(report of 507 cases)
- VernacularTitle:原发性醛固酮增多症(附507例报告)
- Author:
Dingyi LIU
;
Bingfeng SHAO
;
Yu ZHU
- Publication Type:Journal Article
- Keywords:
Adrenal gland neoplasms;
Hyperaldosteronism
- From:
Chinese Journal of Urology
2001;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the diagnosis and treatment of primary aldosteronism. Method 507 cases of primary aldosteronism were reviewed. Result Serum potassium was lower in aldosterone producing adenoma (APA) as compared to idiopathic hypersteronism (IHA) (2.35?0.53) mmol/L vs ( 2.94 ? 0.55 ) mmol/L.Aldosterone in serum and 24h urine were higher in APA than in IHA ( 1 027.67 ? 531.84 )pmol/L and (69.25?43.77) mmol/L vs (781.14?310.24)pmol/L and (37.12?9.99) mmol/L.The diagnosis rate on B ultrasonography was 83.9% and on CT 93.1%.The postural stimulation test was more sensitive in IHA and on imaging procedures both the adenals were increased in size or with small nodule.In aldosterone producing adrenocortical carcinoma (APC),there were pronounce increase of cortisol and dehydroisoandrosterone and the tumor size was usually greater than 5cm.APA and APC should be treated surgically but the prognosis was only favorable for APA not for APC.IHA should be treated medically. Conclusion Serum and urine aldosterone were significantly higher in APA and serum potassium lower than in IHA.Postural stimulation test,B ultrasonography and CT were helpful to the diagnosis of APA.In patients with a single APA especially complicated by adrenal atrophy,partial adnalectomy of the affectd side is indicated whereas total adrenalectomy of the affected side is mandatory if the APA is multiple or there is adrenal hyperplasia.
