原発性アルドステロン症の臨床 : 特に局在診断法について

Abstract

本症7例を検討した.1)年齢を32歳より64歳, 平均51歳で男2例であった.2)高血圧は6例にみとめられた.低K血症を6例にみた.全例, 血漿アルドステロン高値およびPRA低値を示した.3)局在診断法としてCTスキャン, MRIおよび副腎シンチグラフィーはいずれも100%の正診率であった.副腎静脈血サンプリングは83%の例で正診をえた.超音波断層法の正診率は60%であった.4)術後血清K値は2週間以内に全例正常化した.術前高血圧持続期間の比較的短いものは, 術後血圧正常化までの期間が短かった

Seven cases of primary aldosteronism were experienced during the 12 years in the Toyama Medical and Pharmaceutical University Hospital. The majority of cases were between 32 and 64 years old with a mean of 51 years. Two cases were male and 5 were female. Hypertension was observed in 6 cases, but one case had normal blood pressure. Hypokalemia was recognized in 6 cases. The plasma level of aldosterone was high in all cases and all the cases showed low levels of plasma renin activity. Concerning the localization of the lesions, CT scan, magnetic resonance imaging and adrenal scintigraphy revealed an accuracy rate of 100%, each. Therefore, these imaging techniques are very useful tools for identifying the locality of the adenoma. On the other hand, the accuracy rates of adrenal venous aldosterone assay and ultrasonography were 83 and 60%, respectively. The cases with rather short duration of hypertension before surgery returned to normal in blood pressure earlier after the operation than the other cases.