祝之明

• 1:重庆市高血压研究所陆军军医大学大坪医院全军高血压与代谢病中心重庆大坪医院高血压内分泌科

摘要(Abstract)：

<正>原发性醛固酮增多症（primary aldosteronism,PA）是常见的继发性高血压，其罹患率在难治性高血压患者中可达15%～20%，但国内外高血压患者中PA的筛查率不足1%，大量PA患者仍按普通高血压治疗~([1-3])。PA易导致难治性高血压，如诊断与治疗不及时，将显著增加远期卒中、心肌梗死、心房颤动和心力衰竭的风险~([3-6])。PA的主要治疗措施有药物治疗与肾上腺手术切除，但临床常有药物疗效不佳或不能耐受药物的不良反应、不愿手术或无手术适应证的PA患者，有些PA患者即使做过手术，但手术疗效不佳。

关键词(KeyWords)： 肾上腺消融;原发性醛固酮增多症;高血压

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金创新研究群体项目（81721001）;; 陆军军医大学临床医学科研项目（2018XLCIO11）

作者(Author): 祝之明

参考文献(References)：

• [1] Funder JW,Carey RM. Primary aldosteronism:where are we now? where to from here[J]? Hypertension,2022,79(4):726-735.
• [2] Brown JM,Siddiqui M,Calhoun DA,et al. The unrecognized prevalence of primary aldosteronism:a cross-sectional study[J]. Ann Inter Med,2020,173(1):10-20.
• [3] Funder JW,Carey RM,Mantero F,et al. The management of primary aldosteronism:case detection,diagnosis,and treatment:an endocrine society clinical practice guideline[J].J Clin Endocrino Metab,2016,101(5):1889-1916.
• [4] Young WF Jr. Diagnosis and treatment of primary aldosteronism:practical clinical perspectives[J]. J Inter Med,2019,285(2):126-148.
• [5] Hundemer GL,Curhan GC,Yozamp N,et al. Cardiometabolic outcomes and mortality in medically treated primary aldosteronism:a retrospective cohort study[J]. Lancet Diabet Endocrinol,2018,6(1):51-59.
• [6] Williams TA,Lenders JWM,Mulatero P,et al. Outcomes after adrenalectomy for unilateral primary aldosteronism:an international consensus on outcome measures and analysis of remission rates in an international cohort[J]. Lancet Diabetes Endocrinol,2017,5(9):689-699.
• [7] Sacks BA,Sacks AC,Faintuch S. Radiofrequency ablation treatment for aldosterone-producing adenomas[J]. Curr Opin Endocrinol Diabetes Obes,2017,24(3):169-173.
• [8] Ladd MR,Zeiger MA. Who was Dr. William C. Baum[J]?World J Surg,2018,42(8):2437-2443.
• [9] Bolte E,Verdy M,Marc-Aurele J. Studies on new diruretic compounds:spirolactone and chlorothiazide[J]. Can Med Assoc J,1958,79(11):881-888.
• [10] Liang KW,Jahangiri Y,Tsao TF,et al. Effectiveness of thermal ablation for aldosterone-producing adrenal adenoma:a systematic review and meta-analysis of clinical and biochemical parameters[J]. J Vasc Interv Radiol,2019,30(9):1335-1342.
• [11] Fowler AM,Burda JF,Kim SK. Adrenal artery embolization:anatomy,indications,and technical considerations[J]. Am J Roentgenol,2013,201(1):190-201.
• [12] Vorselaars WMCM,van Beek DJ,Postma EL, et al. Clinical outcomes after surgery for primary aldosteronism:evaluation of the PASO-investigators’ consensus criteria within a worldwide cohort of patients[J]. Surgery,2019,166(1):61-68.
• [13] Kempers MJ,Lenders JW,van Outheusden L,et al. Systematic review:diagnostic procedures to differentiate unilateral from bilateral adrenal abnormality in primary aldosteronism[J]. Ann Intern Med,2009,151(5):329-337.
• [14] Rossi GP,Rossitto G,Amar L,et al. Clinical outcomes of 1625 patients with primary aldosteronism subtyped with adrenal vein sampling[J]. Hypertension, 2019, 7 4(4):800-808.
• [15] Wachtel H,Fraker DL. Therapeutic outcomes with surgical and medical management of primary aldosteronism[J]. Curr Cardiol Rep,2021,23(7):89.
• [16] Ohno Y,Naruse M,Beuschlein F,et al. Adrenal venous sampling-guided adrenalectomy rates in primary aldosteronism:results of an international cohort(AVSTAT)[J]. J Clin Endocrino Metab,2021,106(3):e1400-e1407.
• [17] Rossi GP. Primary aldosteronism:JACC state-of-the-art review[J]. J Am Coll Cardiol,2019,74(22):2799-2811.
• [18]祝之明，赵志钢，张和轩，等.肾上腺消融术治疗原发性醛固酮增多症相关难治性高血压：技术关键与应用前景[J].中华心血管病杂志，2021,49(10):951-956.
• [19] Heinrich DA,Adolf C,Holler F,et al. Adrenal insu ffi ciency after unilateral adrenalectomy in primary aldosteronism:longterm outcome and clinical impact[J]. J Clin Endocrinol Metab,2019,104(11):5658-5664.
• [20] Liu SY,Chu CM,Kong AP,et al. Radiofrequency ablation compared with laparoscopic adrenalectomy for aldosteroneproducing adenoma[J]. Br J Surg,2016,103(11):1476-1486.
• [21] Hokotate H,Inoue H,Baba Y,et al. Aldosteronomas:experience with superselective adrenal arterial embolization in 33cases[J]. Radiology,2003,227(2):401-406.
• [22] Parksook W W,Yozam p N,Hundemer G L,et al.Morphologically normal appearing adrenal glands as a prevalent source of aldosterone production in primary aldosteronism[J].Am J Hypertens,2022,35(6):561-571.
• [23] Sun F,Hong Y,Zhang H,et al. Determination of adrenal hypersecretion in primary aldosteronism without aldosteroneproduction adenomas[J]. BMC Endocr Disord,2021,21(1):114.
• [24] Zhang H,Li Q,Liu X,et al. Adrenal artery ablation for primary aldosteronism without apparent aldosteronoma:an efficacy and safety,proof-of-principle trial[J]. J Clin Hypertens(Greenwich),2020,22(9):1618-1626.
• [25] Zhao Z,Liu X,Zhang H,et al. Catheter-based adrenal ablation remits primary aldosteronism:a randomized medication controlled trial[J]. Circulation,2021,144(7):580-582.
• [26] Dong H,Zou Y,He J,et al. Selective adrenal arterial embolization for idiopathic hyperaldosteronism:12-month results from a proof-of-principle trial[J]. Catheter Cardiovasc Interv,2021,97 Suppl 2:976-981.
• [27] Guo RQ,Li YM,Li XG. Comparison of the radiofrequency ablation versus laparoscopic adrenalectomy for aldosterone producing adenoma:a meta-analysis of perioperative outcomes and safety[J]. Updates Surg,2021,73(4):1477-1485.
• [28] Lauder L,Azizi M,Kirtane AJ,et al. Device-based therapies for arterial hypertension[J]. Nat Rev Cardio,2020,17(10):614-628.
• [29] Rossi GP,Bisogni V,Bacca AV,et al. The 2020 Italian society of arterial hypertension(SIIA)practical guidelines for the management of primary aldosteronism[J]. Int J Cardiol Hypertens,2020,5:100029.
• [30] Kiseljak-Vassiliades K,Bancos I,Hamrahian A,et al. American association of clinical endocrinology disaeas state clinical review on the evaluation and management of adrenocortical carcinoma in an adult:a practical approach[J]. Endocr Pract,2020,26(11):1366-1383.
• [31] Fassnacht M,Dekkers O,Else T,et al. European Society of Endocrinology Clinical practice guidelines on the management of adrenocortical carcinoma in adults,in collaboration with the European Network for the Study of Adrenal Tumors[J]. Eur J Endocrino,2018,179(4):G1-G46.
• [32]中国医师协会介入医师分会肿瘤消融专业委员会，中国临床肿瘤学会肿瘤消融治疗专家委员会.影像引导下肾上腺肿瘤消融治疗专家共识（2019版）[J].中华医学杂志，2019,99(15):1123-1132.