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目的:通过回顾58例确诊为原发性醛固酮增多症(PA)患者的主要症状,提高对该病的认识;并评价这些症状对PA的诊断意义。方法:回顾性分析58例PA患者的主要症状包括高血压、低钾血症等;总结其在这些患者中的发生情况。结果:全部患者伴有高血压,以高血压为首发症状的患者占96.6%,其中1级高血压12例(20.7%),2级33例(56.9%),3级13例(22.4%);伴肌无力、乏力或肌麻痹的占53.4%。48例(83%)有低血钾,平均血钾浓度为(2.84±0.49)mmol/L,24h尿钾排泄[(51.90±38.0)mmol/L],增高者(>25 mmol/24h)占95%;血钠增高(>145 mmol/L)者占48.3%。结论:原发性醛固酮增多症患者一般均有高血压并低血钾,对于有高血压并低血钾者应高度怀疑原发性醛固酮增多症,作进一步特殊检查,早日确诊。
OBJECTIVE: To improve the understanding of the disease by reviewing the major symptoms of 58 patients with primary aldosteronism (PA) and to evaluate the diagnostic value of these symptoms for PA. Methods: The main symptoms of 58 patients with PA were retrospectively analyzed including hypertension, hypokalemia and so on. Their occurrence in these patients was summarized. Results: All the patients had hypertension, and the first symptom of hypertension was 96.6%. Among them, grade 1 hypertension was in 12 cases (20.7%), grade 2 in 33 cases (56.9%), grade 3 in 13 cases (22.4%), ; With weakness, fatigue or muscle paralysis accounted for 53.4%. 48 cases (83%) had hypokalemia, mean serum potassium concentration was (2.84 ± 0.49) mmol / L, 24h urine potassium excretion [(51.90 ± 38.0) mmol / L] 95%; the increase of serum sodium (> 145 mmol / L) accounted for 48.3%. CONCLUSIONS: Patients with essential aldosteronism generally have hypertension and hypokalemia. Patients with high blood pressure and hypokalemia should be highly suspected of primary aldosteronism for further special examination and early diagnosis.