【摘要】 【目的】探讨继发性高血压与垂体微腺瘤的联系及垂体微腺瘤的核磁共振成像(MRI)诊断价值。【方法】分析比较21例高血压伴垂体微腺瘤患者的临床、实验室检查和影像学资料。【结果】21例患者的主要表现:(1)发病年龄较轻,均有头痛症状;(2)24 h动态血压监测(24 h ABPM)显示血压昼夜节律消失,收缩压/舒张压明显增高;(3)服用降压药降压效果不明显;(4)腺垂体激素中,促肾上腺皮质激素(ACTH)大多数病例超过正常值,少数病例的泌乳素(PRL)超过正常值,其余激素正常;(5)部分病例MRI提示肾上腺皮质增生、肾上腺腺瘤、嗜铬细胞瘤;(6)全部病例MRI提示垂体微腺瘤。【结论】对于药物降压效果不佳的高血压中青年患者,应常规进行肾上腺、特别是垂体MRI检查,而MRI是诊断垂体微腺瘤的最佳影像学方法,对中医辨证论治也具有重要的参考价值。更多还原

【Abstract】 Objective To investigate the relationship between the secondary hypertension and pituitary microadenoma,and to explore the diagnostic value of magnetic resonance imaging(MRI) examination for pituitary microadenoma.Methods We analyzed the clinical information,laboratory examination results and imaging data in 21 hypertension patients complicated with pituitary microadenoma.Results The manifestations of the 21 patients were as follows:(1) The onset of hypertension was in young age,complicated with headache;(2) The results of 24-hour ambulatory blood pressure monitor(24h ABPM) showed the disappearance of circadian rhythm of blood pressure,and obvious increase of systolic/diastolic blood pressure;(3) The antihypertensive effect of antihypertensive drugs was not satisfactory;(4) Of adenohypophyseal hormones,adrenocorticotrophic hormone(ACTH) level in most patients and prolactin(PRL) level in a few patients were higher than the normal level,and the other hormones levels were normal;(5) The results of MRI examination presented adrenal cortical hyperplasia,adrenal adenoma and chromaffin tumor in some patients.(6) The results of MRI examination showed pituitary microadenoma in all of the patients.Conclusion For those middle-aged and young hypertension patients on whom antihypertensive effect of drugs is poor,MRI examination for adrenal gland and pituitary gland should be taken as the routine examination.MRI examination is the optimal imaging method for pituitary microadenoma,and supply evidence for the syndrome differentiation and treatment of pituitary microadenoma.更多还原