原发性醛固酮增多症患者的糖脂代谢异常及治疗转归

【中图分类号】R586.9 【文献标志码】A

【Abstract]Patients with primaryaldosteronism（PA）hadasignificantly higherriskofabnormalglucosemetabolismcompared with thosewitheentialhypertension（EH），hichmightbeasoiatedwiththemehansmssuchasaldosteroninducedimpitfinsulinsignaltrsuci，ellopoisssisaIdiiitsitd metabolismaswell，althoughresearchfindingsremaininconsistent，ndafewsudieshaveshownthatPApatientsayhavealower leveloftriglycerides thanEHpatients.Furthermore，smallumbeofsudieshaveiglightedtetreatmentoutcomsofglucoseand lipidmetabolisminPApatints.Unilateraladrenalectomyapearstobemorebeneficialinimprovingglucosemetabolismhreas amongmineralocorticoidreceptorantagonists，spirolactonemayexertanadversefectonblood glucose，hileplerenonemayeerta neutralorpotentiallbeneficialefect.Somepatientsexperencedeteriorationof ipidmetabolismanddeclineinrenalfunctionafter treatment，hichigtbessociatedwithtepreseneofchroncideyinjuryaftertesolutioofglomerularherfiltratio fore，earlyassessmentofucoseandlipidmetablsadadovaularsksouldbeperfdopatntsndtreattate giesshouldbeselectedaccording tothesubtypeofPA.Long-term maagementshouldincludethe monitoringandtreatmentofglucose andlipidmetabolicparameterstobeterimprovetheprognosisofpatients.Prospectivestudiesshouldbeconductedtoclarifythaso ciationbetweenglucoseandlipidmetabolicabnormalitiesandcardiovascularcomplications inPApatientsanddevelopoptialtervention strategies.

【Key wordsJprimary aldosteronism;glucose and lipid metabolic disorders;treatment outcome;long-term management

原发性醛固酮增多症（primaryaldosteronism，PA）是一种常见的内分泌性高血压，其特征为肾上腺自主分泌醛固酮，肾素活性受抑制，临床表现为高血压伴或不伴低钾血症，在我国新诊断高血压人群的患病率超过 4% ]。（剩余15082字）