內(nèi)分泌性高血壓的診斷_冰山一角-展示頁(yè)
2025-01-07 02:44本頁(yè)面
【正文】 unlikely Confirmatory testing unlikely + + Adrenal CT If surgery not desired If surgery desired MR antagonist AVS bilaleral unilateral Laparoscopic adrenalectomy 二、 Cushing綜合征未受重視 病例 1： 女性患者 ， 60歲 。 問(wèn)題： 怎么明確低鉀血癥的病因 ？ Diagnosis Ⅰ . Suspicious Conditions ① BP160/100mmHg. ② drug resistant HT (hypertention). ③ HT+K↓. ④ HT+diureticinduced K↓. ⑤ Spontaneous K↓. ⑥ HT+adrenal incidetaloma. ⑦ HT+a family history of earlyonset HT. ⑧ HT+cerebrovascular accident at a young age (40y). ⑨ all hypertensive firstdegree relatives of patients with PA. ReninAngiotensinAldosterone system (RAAS) (RAA axis) Angiotensinogen (a2globulin, liver) Renin (Juxtaglomerular Cells of Glomerulus)→RR AngiotensinⅠ (ATI) ACE (Angiotensin Converting Enzyme) (LungVEC, glomerulus, brain,…) Chymase (ventricle) ATⅡ （ R1， R2） ATⅡ R1 Aldosterone secrection Sympathetic activation vasoconstriction Blood pressure regulation ARR cutoff values for PA PRA ng/ml/h PRA pmol/L/min DRC mu/L DRC ng
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