The Observation And Analysis Of Clinic Effect Of Hypertension With Adrenal Hyperplasia Treated By Adrenalectomy

ObjectiveTo explore clinic and pathology’s characteristic of patients with hypertension withadrenal hyperplasia, estimate surgical therapy effect and analyse the fators of differenteffect.MethodsThe clinical data of patients with hypertension of adrenocorticotropichormone-independent adrenal hyperplasia who were diagnosed and treated by ourhosipital from January to December in2012were retrospectively analyzed, include sex,age, duration of symptom, clinical symptom, incretion check, iconography beforeoperation and pathological type after operation. Follow up and observe improvement ofclinical symptom, blood pressure and change of antihypertensive drugs by telephone.Estimate surgical therapy effect, analyse the fators of different effect.analyse questionwhich we encounter in diagnosis and tretment.ResultsSeventy-five cases were followed-up, thirty-nine cases were male and thirty-sixwere female.Age from twenty to seventy-four years, and averaged age is forty-seven.Pathology result: diffusivity hyperplasia in42cases(56%),tubercle hyperplasia in26cases(26%), mixed corticomedullary pathological changes in adrenal in6cases(8%).we take11-21months to obesver these cases, An average follow-up time was15.6months.We divide them to three groups according to their postoperation blood pressure andsymptom, curative group, improved group, ineffectived group.Curative groups: normalblood pressure or symptom was dissolved, when we don’t use medicine; Improvedgroups:blood pressure descend or symptom was improved,as we reduce medicine ornot,and we don’t use medicine. Ineffectived groups: blood pressure and symptom werenot improved, when we use same medicine as operation before. The proportion was31.2%,56.2%,13.3%respective in curative, improved and ineffectived groups. There isremarkable difference between the blood pressure before operatio and postoperation,andthe difference has statistical significance. Besides, we find that the age,blood pressurelevel and the course of disease may make some influence to clinic effect,whereas,the sex,side, postoperation time and pathology style are not include.ConclusionFor most patients, we can control blood pressure and clinical symptom byadrenalectomy. Adrenalectomy is an effective and safe method that benefits somepatients possibly for adrenal hyperplastic hypertension.We should control blood pressurebefore operatio and measure blood pressure postoperation continually.The age,bloodpressure level and the course of disease may make some influence to cliniceffect,whereas,the sex, side, postoperation time and pathology style are not include.Besides,Most of patients have merely hypertension or headache, dizziness. Therefore, weshould think that whether the adrenal has changes or not for these patients, meanwhile,we can make patients to do some iconography and incretion check in adrenal. On theother hand, the symptom, iconography and incretion check in adrenal are not accordingcompletely, so we make initial diagnosis according to combine with three above respectsand our final diagnosis are depended on pathology.