發(fā)布時間：2018-05-23 19:33

  本文選題：繼發(fā)性高血壓 + 腎上腺疾病�。� 參考：《山東大學》2017年碩士論文

【摘要】：背景:高血壓疾病是臨床上最常見的疾病之一,全世界范圍內(nèi)約14億的成人患病,在我國估計至少有2億患者飽受其困擾。長期高血壓狀態(tài)極易引起心臟、腦、腎臟等靶器官的損害,表現(xiàn)出頭暈、頭痛、心悸、耳鳴等癥狀,極大地影響生活質(zhì)量,危害生命健康。對于繼發(fā)性高血壓,特別是腎上腺疾病所致的高血壓者,其發(fā)病率在近年來逐漸升高,而此類患者手術(shù)治療效果較為顯著。因此,鑒別高血壓的發(fā)病原因,使治療有的放矢,改善患者預(yù)后,顯得尤為重要。目的:研究高血壓患者腎上腺切除術(shù)后血壓的變化,探討其影響影響因素方法:本文統(tǒng)計了本病區(qū)從2014-2016年患腎上腺疾病合并高血壓的181例臨床資料,所有患者均行腎上腺切除術(shù),所有影響因素均通過logistics回歸分析。結(jié)果:經(jīng)過分析研究,有107(59.1%)例完全緩解,而67(37.0%)例部分緩解,最后有7(3.9%)例的患者仍為抵抗性高血壓。多于2種抗高血壓藥物的使用P0.001),高血壓病程p0.001),低血鉀病程(p= 0.038),收縮壓(p = 0.016)以及醛固酮水平(p0.001)可能與之密切相關(guān)。但是logistics曲線分析顯示只有術(shù)前抗高血壓藥物使用的種類2種(OR = 0.602,95%CI 0.410-0.783,p = 0.001),高血壓病程≥6年(OR = 0.496,95%Cl 0.323-0.762,p=0.001)以及血漿醛固酮水平 ≥ 35 ng/dl(OR = 0.503,95%CI 0.326-0.776,;p = 0.001)才是特異性的指標。結(jié)論:這項研究涵蓋眾多患者,顯示只有高血壓病程,術(shù)前服藥數(shù)量以及血漿醛固酮水平才是影響腎上腺切除術(shù)后患者的血壓水平的因素。因此這項研究最終強調(diào)了腎上腺性高血壓需要早發(fā)現(xiàn),早治療,以免引起不理想的降壓的效果。
[Abstract]:Background: hypertension is one of the most common diseases in clinic. About 1.4 billion adults worldwide suffer from hypertension. Long-term hypertension is easy to cause heart, brain, kidney and other target organ damage, showing dizziness, headache, palpitations, tinnitus and other symptoms, greatly affect the quality of life, endangering life and health. The incidence of secondary hypertension, especially that caused by adrenal diseases, has increased gradually in recent years. Therefore, it is very important to distinguish the causes of hypertension, to improve the prognosis of patients. Objective: to study the changes of blood pressure after adrenalectomy in patients with hypertension. Methods: 181 cases of adrenal diseases complicated with hypertension from 2014-2016 in our hospital were analyzed. All patients underwent adrenalectomy and all influencing factors were analyzed by logistics regression analysis. Results: after analysis, there were 107 cases of complete remission, 67 cases of partial remission, and finally 7 cases of 3. 9% of the patients were still resistant to hypertension. The use of more than 2 antihypertensive drugs, the course of hypertension, the course of hypokalemia, the course of hypokalemia and systolic blood pressure (P = 0.016) and aldosterone level (p 0.001) may be closely related to it. But the logistics curve analysis showed that only the two kinds of antihypertensive drugs used before operation, CI 0.410-0.783p = 0.001, the duration of hypertension 鈮，

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