Aldosteronomas-State of the Art

被引：13

作者：

McKenzie, Travis J. ^{[1
]}

Lillegard, Joseph B. ^{[1
]}

Young, William F., Jr. ^{[2
]}

Thompson, Geoffrey B. ^{[1
]}

机构：

[1] Mayo Clin, Dept Surg, Rochester, MN 55905 USA

[2] Mayo Clin, Dept Med, Div Endocrinol, Rochester, MN 55905 USA

来源：

SURGICAL CLINICS OF NORTH AMERICA | 2009年 / 89卷 / 05期

关键词：

Primary aldosteronism; Aldosterone-producing adenoma; Aldosteronoma; Idiopathic hyperplasia; Adrenal vein sampling; PLASMINOGEN-ACTIVATOR INHIBITOR-1; RENIN-ANGIOTENSIN SYSTEM; LAPAROSCOPIC ADRENALECTOMY; PLASMA-ALDOSTERONE; PRIMARY HYPERALDOSTERONISM; HYPERTENSIVE PATIENTS; SURGICAL-TREATMENT; SCREENING-TEST; UNILATERAL ADRENALECTOMY; PERSISTENT HYPERTENSION;

D O I：

10.1016/j.suc.2009.06.017

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Primary aldosteronism (PA) is the most common cause of secondary hypertension in nonsmokers. Widespread screening of unselected hypertensives has identified PA in as many as 15% of patients. With such screening efforts using the PAC/PRA ratio and PAC, the widespread prevalence of the disease has become apparent while the relative percentage of APA has decreased. PA is confirmed by demonstrating lack of aldosterone suppressibility with sodium loading. Subtype evaluation is best achieved with high resolution CT scanning and AVS in the appropriate setting. In patients with PA and a unilateral source of aldosterone excess, laparoscopic adrenalectomy is the treatment of choice with excellent outcomes and low morbidity as compared with older open approaches. Patients with IHA, or those not amenable or agreeable to surgery, are best managed with a MR antagonist.

引用

页码：1241 / +

页数：14

共 93 条

[1]

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