Clinical Analysis Of 244 Cases Of Adrenal Disease

Objective :After comparing the patients who suffering from the adrenal disease in three age groups (old-aged group, middle-aged group and youth group), to research the clinical characteristcs of elderly patients suffered from the disease and to investigate the diagnosis and treatment of senile adrenal disease.Methods: Retrospective analysis of the medical records of 244 patients with adrenal gland diseases admitted to our hospital from 2003 to 2007.Pathological diagnosis combined with clinical manifestation, endocrinic hormone and biochemical laboratory examination were regarded as classified criteria of disease.Data in forms was analysised to compare the frequency of disease symptoms, types of distribution, the distribution of disease in different age groups of patients, and the biochemical indicators, tumor size, position, shape, the treatment and its effect in similar diseases among all age groups.Results: Our study showed that the proportion of non-functioning adrenal tumors was the largest in old aged group.Some elderly patients had typical symptoms, which overlapped with other age-related disease's symptoms, and some elders's clinical manifestation was non-typical.Three age groups of patients had a similar change with serum sodium and synchronous 24-hour urine sodium, as well as supine renin, angiotensinâ…¡, 24-hour urine VMA, and ARR, however supine aldosterone levels was on a downward trend with age.Laboratory diagnostic criteria of adrenal disease also applied to elderly patients.Imaging prompted that the tumors of the three age groups had no significant differences in location, the size of tumor roughly equaled, but adrenal hyperplasia lesions showed an increase in the proportion of adrenalopathy with age.Surgery was the main mode to treat the functioning adrenal tumors in three age groups, as well as periodic inspection and antihypertensive drug treatment were the main mode to non-functioning.With age, patients with primary aldosteronism had a preference for the trend of conservative treatment, and the proportion of patients who needed antihypertensive drug at postsurgery increased.Conclusions:To sum up, the clinical manifestation of adrenal diseases is similar in three age groups, but the diagnosis is more difficult with the elder.Supine aldosterone levels was on a downward trend with age.Adrenal hyperplasia lesions showed an increase in the proportion of senile adrenal disease.The proportion of nonfunctioning adrenal tumors is the largest in elderly patients.The treatment of elderly patients need to be chosen after a comprehensive evaluation to the pathogenetic conditions.