第二节原发性醛固酮增多症（Second cases of primary aldosteronism）.docVIP

第二节原发性醛固酮增多症（Second cases of primary aldosteronism） Second cases of primary aldosteronism Primary aldosteronism (Primary hyperaldosteronism) referred to as primary aldosteronism, the body is due to excessive secretion of aldosterone caused typical manifestations of hypertension, high aldosterone, hypokalemia and alkalosis and renin, muscle or weak and feeble periodic paralysis. Conn was first described by Conn in 1953, so it is also known as the syndrome. Clinically, aldosterone secreting adrenal tumors and primary adrenal hyperplasia (Adrnal, cortical, hyperplaisa), as well as aldosterone, which is not in the adrenal gland, need to be identified. Etiology and pathology The most common 1. adrenocortical adenoma, accounting for about 80% of primary aldosteronism, with single adrenal tumors, aldosteronomas smaller, the majority of diameter less than 3 cm, there is only 0.3 of the 0.6 cm, the average diameter is 1.8 Cm, the weight of the majority of 3 to 59?. 2. idiopathic aldosteronism may be caused by a factor outside the adrenal gland that is stimulated by aldosterone. The disease is sensitive to angiotensin. In standing position, renin activity and aldosterone secretion increase. It is believed that the disease is a component of a variety of clinical forms of essential hypertension. 3. primary adrenal hyperplasia is rare. The results of endocrine and biochemical measurements are similar to those of cortical adenoma, and unilateral adrenalectomy or subtotal adrenalectomy is effective. 4. aldosterone producing adrenal adenocarcinoma tumor diameter is often greater than 3 cm, the capsule is often infiltrated, because cancer cells can also secrete glucocorticoids and sex hormones, and may have corresponding clinical manifestations. 5. corticosteroids can inhibit primary aldosteronism with unknown etiology, 17a hydroxylase deficiency, usually have a family history, can appear high plasma aldosterone and similar primary aldosteronism, plasma deoxycorticosterone increased