【摘要】 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。更多还原

【Abstract】 Objective To investigate the factors regarding the recovery of postoperative blood pressure of aldosterone producing adenoma(APA)patients. Methods Sixty-eight patients with APA were recruited and their data including retinal blood vessel by Doppler sonography,urinary trace albumin,pathological changes of renal biopsy and the adrenal tissues around the adenoma were analyzed in order to determine the correlation between these data and postoperative durative hypertension. Results Postoperature durative hypertension occurred in 14 cases (41.2%) with increased resistance of unilateral or bilateral central artery of retina,in 16 cases (66.7%) with increased level of urinary trace albumin.Fifteen cases underwent renal biopsy and all of them showed different pathological alterations,11 cases (73.3%) of which presented with postoperative durative hypertension.The pathological changes of the adrenal tissues around the adenoma is either atrophy or non-atrophy (normal or hyperplasia),8 cases (40%) and 10 cases (22.2%) of which showed postoperative durative hypertension,respectively. Conclusion The renal pathological changes and increased resistance of retinal blood vessel are the main reasons leading to postoperative hypertension in patients with APA.更多还原