| Objective: 1.Through the baseline investigation of the status and diagnosis and treatment of primary aldosteronism and pheochromocytoma in the Third Division of Southern Xinjiang,to understand the awareness rate,disease detection rate,diagnosis and treatment rate,standard blood pressure rate and MDT diagnosis and treatment of local medical staff and patients.2.Formulated standardized MDT diagnosis and treatment schemes for two diseases in the Third Division of Southern Xinjiang,carried out demonstration application and promotion in the Third Division of Southern Xinjiang,and evaluated the effect;3.To explore the risk factors affecting primary aldosteronism and pheochromocytoma,and to provide evidence for their prevention and treatment.Methods: 1.A total of 1979 patients with highly suspected secondary hypertension and 97 medical workers were included in the study.2.A questionnaire was developed for medical staff to understand their awareness rate of primary aldosteronism and pheochromocytoma as well as the MDT diagnosis and treatment of the disease;Questionnaire was developed to understand the awareness rate,detection rate,diagnosis and treatment rate of the two diseases and the rate of blood pressure reaching the standard.Members of the research group assisted the subjects to fill in the questionnaire after training.General baseline data such as blood pressure and heart rate were measured and recorded.Electrolytes,blood catecholamine(CA),plasma renin activity(PRA),plasma aldosterone concentration(PAC)and other indicators were detected and recorded.Adrenal enhanced CT examination was performed.3.Formulated standardized MDT diagnosis and treatment programs for primary aldosteronism and pheochromocytoma in the third Division of Southern Xinjiang,and promoted and applied them.4.Effect evaluation after the implementation and application of standardized MDT diagnosis and treatment scheme: to compare the awareness rate,detection rate,diagnosis and treatment rate of the two diseases of medical staff and patients and the rate of blood pressure reaching the standard;The lifestyle changes of patients before and after MDT were compared.Biochemical parameters such as electrolyte before and after MDT were compared.5.Use SPSS26.0 to analyze survey data.Percentage was used to compare counting data and Chi-square test was used to compare between groups.Conform to the normal distribution of measurement data using x?±s,between group by t test;The non-normal distribution was represented by M(P25,P75),and the rank sum test was used for comparison between groups.Logistic regression analysis was used to analyze risk factors,and P < 0.05 was statistically significant.Results: 1.The detection rate of secretory hypertension was low(4.2%)in the third division of Southern Xinjiang.The detection rates of primary aldosteronism and pheochromocytoma were 3.5% and 0.3%,respectively.The total awareness rates of medical staff were 15.7% and 15.9%,the awareness rates of physician group were 25.3% and 26.2%,and the awareness rates of nursing group were 8.8% and 8.3%(P< 0.01).The awareness rates of primary aldosteronism and pheochromocytoma were 5.5% and 5.2%,respectively.38.8% of patients with hypertension were treated with drugs,0.3% with surgery,31.0% with drugs for primary aldosteronism,3.2% with surgery.The proportion of drug therapy for pheochromocytoma was 53.0%,and that of surgical treatment was 11.8%.The rate of blood pressure reaching the standard was 11.0%,and the rate of primary aldosteronism and pheochromocytoma reaching the standard was 8.1% and 11.8%,respectively.2.After the application of standardized MDT diagnosis and treatment protocol,the detection rate of secretory hypertension increased(15.1%),the detection rate of primary aldosteronism and pheochromocytoma were 10.6% and 1.7%,respectively;The awareness rate of primary aldosteronism in physician group and nursing group was increased to 61.2% and 32.3%,respectively,and the awareness rate of pheochromocytoma was increased to 58.5% and 33.9%.The awareness rates of the two diseases were increased to 32.8% and 36.2% respectively.The proportion of drug and surgical treatment in hypertension patients increased significantly(38.8% vs 67.3%,0.3% vs3.3%),and the proportion of surgical treatment for primary aldosteronism and pheochromocytoma was17.1% and 85.3%,respectively.The rate of blood pressure reaching the standard was increased to 49.9%,57.1% for primary aldosteronism and 85.3% for pheochromocytoma(P < 0.01).3.Multivariate Logistic regression analysis showed that drinking alcohol and family history of hypertension were common risk factors for primary aldosteronism and pheochromocytoma.Conclusions: 1.The awareness rate of primary aldosteronism and pheochromocytoma is low among medical staff and patients in the third division of southern Xinjiang,and the rate of disease detection,diagnosis and treatment,and the rate of blood pressure reaching the standard are all low.There is a lack of standardized MDT diagnosis and treatment team.2.After the application of standardized MDT diagnosis and treatment scheme in southern Xinjiang,the awareness rate of PA and PCC among medical staff and patients increased,the detection rate of these two diseases in patients with highly suspected secondary hypertension increased significantly,and the diagnosis and treatment rate of diseases and the rate of blood pressure reaching the standard also increased;3.Changing the unhealthy lifestyle of drinking alcohol is beneficial to the prevention and treatment of primary aldosteronism and pheochromocytoma. |
