原发性醛固酮增多症伴横纹肌溶解症病例报道并文献复习

发布时间：2018-06-07 04:25

本文选题：原发性醛固酮增多症 + 横纹肌溶解　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的:探讨原发性醛固酮增多症(简称原醛症)伴横纹肌溶解症的临床特点以指导对该病的诊治。方法:通过对我院诊断的2例原醛症伴横纹肌溶解症患者及在中国知网数据库、维普数据库、万方数据库、Pub Med等数据库中以“原发性醛固酮增多症、低钾血症、横纹肌溶解”、“primary aldosteronism;、hypokalemia;、rhabdomyolysis”为关键词检索相关文献中诊断为原发性醛固酮增多症伴横纹肌溶解的19例该病患者进行分析。结果:所有患者均有高血压病史,主要表现为乏力、肌痛、低钾血症及高肌酶谱,少部分患者有肌红蛋白尿、肾损伤及转氨酶异常。经大量补液、碱化尿液等对症治疗,横纹肌溶解得以纠正;经过手术或药物治疗后血钾、血压恢复正常。结论:对于原醛症的高危人群应尽早进行筛查,可避免病情进展而导致横纹肌溶解等严重并发症的发生;对于确诊为原醛症的患者,血钾低于2.0 mmol/L的醛固酮腺瘤应警惕横纹肌溶解的发生。已出现横纹肌溶解的原醛症患者,应在积极对症治疗的基础上根治原发病。
[Abstract]:Objective: to investigate the clinical features of primary aldosteronism with rhabdomyolysis. Methods: two cases of proaldehydes with rhabdomyolysis were treated with "primary aldosteronism, hypokalemia, rhabdomyolysis" in the database of Chinese knowledge network, Weip database, Wanfang database and so on. "primary aldosteronismmonium hypokalemiae rhabdomyolysis" was used to search for 19 cases of primary aldosteronism with rhabdomyolysis diagnosed as primary aldosteronism with rhabdomyolysis. Results: all patients had a history of hypertension, including fatigue, myalgia, hypokalemia and hyperlipidemia. A few patients had myoglobin, renal injury and abnormal transaminase. Rhabdomyolysis can be corrected by a large amount of fluid rehydration, alkali urine and other symptomatic treatments; after surgery or drug treatment, blood potassium and blood pressure return to normal. Conclusion: screening should be carried out as early as possible to avoid serious complications such as rhabdomyolysis caused by progression of the disease. Aldosterone adenomas with blood potassium below 2.0 mmol/L should be on guard against rhabdomyolysis. The patients with rhabdomyolysis should cure the primary disease on the basis of active treatment.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R586.24;R685.5

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