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| 特发性醛固酮增多症心肌重构与螺内酯治疗 |
| 叶菲,汤正义*,吴景程,杨洋,田秀丽,黄佳佳,徐茜,张杉杉,李小英,王卫庆,宁光 |
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| (上海交通大学医学院附属瑞金医院内分泌代谢病科,上海市内分泌代谢病临床医学中心,上海 200025) |
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| 摘要: |
| 目的探讨原发性醛固酮增多症(primary aldosteronism,PA)患者心室重构的情况,观察特发性醛固酮增多症(idiopathic hyperaldosteronism,IHA)患者在经过螺内酯治疗后的心肌重构转归,以及这种转归与血压、血醛固酮的关系。方法收集172例PA患者作为实验组,100例原发性高血压(essential hypertension,EH)患者作对照组。收集两组病史资料,比较两组一般临床资料、生化指标、激素水平,以及主动脉根部内径(AO)、左房内径(LAd)、左室舒张末内径 |
| 关键词: 特发性醛固酮增多症 螺内酯 心室重构 |
| DOI：10.3724/SP.J.1008.2011.0697 |
| 投稿时间：2011-03-21修订日期：2011-06-16 |
| 基金项目: |
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| Cardiac structural changes in idiopathic hyperaldosteronism and treatment with spironolactone |
| YE Fei,TANG Zheng-yi*,WU Jing-cheng,YANG Yang,TIAN Xiu-li,HUANG Jia-jia,XU Qian,ZHANG Shan-shan,LI Xiao-ying,WANG Wei-qing,NING Guang |
| (Department of Endocrinology and Metabolism, Ruijin Hospital, School of Medicine of Shanghai Jiaotong University, Shanghai Clinical Centre for Endocrine and Metabolism Diseases, Shanghai 200025, China) |
| Abstract: |
| Objective: To analysis the cardiac structural changes of patients with primary aldosterone (PA) and the evolution after treatment with spironolactone in idopathic hyperaldosteronism (IHA). The association between cardiac structutal changes and aldosteronism levels and treatment with spironolactone is also investigated.
Methods: 172 patients with PA were enrolled and 100 patients with essential hypertension (EH) served as control group. All the clinical data of these patients were collected. At baseline, biochemical, hormones and echocardiographic parameters of PA group were compared with those of patients with EH. During follow-up, 38 patiens with idopathic hyperaldosteronism (IHA) who were given spironolactone underwent biochemical, plasma aldosterone level and echocardiographic assements. The clinical data including blood pressure, aldosteronism levels and echocardiographic parameters after follow-up were compared with those data on baseline in those patients for analyzing.
Results: Ventricular volumes，wall thickness and left ventricle mass index (LVMI) were greater in patients with EH than PA (P<0.01) and positively correlated with systolic blood pressure (P<0.05). LVMI decreased significantly in patients with IHA after follow-up (P<0.01), and the major influence factor was the plasma aldoterone level lowing.
Conclusion: Cardiac structural changes greater in PA group compared with EH group and positively correlated with systolic blood pressure. Treatment with spironolactone would ameliorate the cardiac structural changes especially the cardiac hypertrophy in patients with IHA. |
| Key words: idiopathic hyperaldosteronism spironolactone ventricular remodeling |
