Effects Of Hypertension With Adrenal Hyperplasia Treated By Adrenalectomy And Influencing Factors

OBJECTIVETo observe the outcomes of hypertension with adrenal hyperplasia treated by adrenalectomy and to approach clinical factors that correlate with the prognosis.That may be reference for practical clinics.METHODSThe participants in this study were 156 patients who underwent adrenalectomy for hypertension with adrenal hyperplasia in Department of Urology of the Guangzhou General Hospital of Guangzhou Military Command from December 2001 to December 2008 general data(age,gender,duration of symptoms,preoperative blood pressure,side of adrenal hyperplasia), preoperative biochemical test results correlated with adrenal(blood potassium, blood cortisol rhythm, aldosterone/renin ratio,24-hour urine catechu amine metabolites),details of operation(blood lost, operation time) and pathological type were collected.follow up postop.blood, improvement of clinical symptoms and change of antihypertensive drugs by telephone, Through the Statistical calculations to assessment effects of of hypertension with adrenal hyperplasia treated by unilateral adrenalectomy, and analysis correlations btween the prognosis and 10 factors including age, gender, disease duration, preoperative blood pressure, side, blood cortisol rhythm, potassium, aldosterone/renin ratio,24-hour urine catechu amine metabolites, pathological type.Statistical processing:SPSS13.0 statistical software was used for data processing and statistical analysis. Measurement data were recorded by mean±standard deviation(x±s).First,Single-factor analysis was carried out in each factors, comparation of count data between the three groups used multiple independent samples rank sum test(Krudkal-Wallis H test), comparation of count data between two groups used two independent samples rank sum test(Mann-Whitney U test),then binary Logistic regression analysis was used in the suspicious factors,with P<0.05 for significant difference.RESULTSAn average follow-up time was more than 6 months.145 cases were followed-up,11 cases were lost,73 cases were male and female 72 cases, cured 71 patients (49.0%), improved in 61 cases (42.1%), ineffective in 13 cases (9.0%), the Efficient was 91.1%. The statistical analysis revealed that the three factors including age, duration of symptoms and pathological types can affect the prognosis of hypertension with adrenal hyperplasia treated by adrenalectomy.Group of the Youth(<45) or duration of symptoms<1 year have the best results, group of the Middle-aged (44-64) or 1 year65) or duration of symptoms>10 years have the worst results,group of adrenal hyperplasia has the better results than group of adrenal mixed corticomedullary. The affect of the factors including gender, side, preoperative blood pressure, serum cortisol rhythm, potassium, aldosterone/renin ratio,24-hour urine catechu amine metabolites on the prognosis of hypertension had not statistically significant difference.CONCLUSIONThe effects of hypertension with adrenal hyperplasia treated by unilateral adrenalectomy is well.Patient's age, duration of symptoms and pathological types have the correlation with the prognosis,can be used as good indicators of prognosis, but gender, side, preoperative blood pressure, serum cortisol rhythm, potassium, aldosterone/renin ratio,24-hour urine catechu amine metabolites can not be accurate indicators of prognosis.