MANAGEMENT OF ENDOCRINE DISEASE: The role of surgical adrenalectomy in primary aldosteronism.
MANAGEMENT OF ENDOCRINE DISEASE: The role of surgical adrenalectomy in primary aldosteronism.
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DOI：
10.1530/eje-20-0863
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发表时间：
2020-12
影响因子：
5.8
通讯作者：
Vaidya A
中科院分区：
文献类型：
--
作者：
Hundemer GL;Vaidya A
原发性醛固酮增多症很常见，可导致心血管、肾脏和代谢方面的不良后果。如果及早有效地实施靶向治疗，可以减轻这些不良后果。手术肾上腺切除术是最有效的治疗方法之一，因为它有可能治愈或减轻病理性醛固酮过量的严重程度，从而导致一系列生化和临床变化，改善健康结果。在此，我们回顾了手术肾上腺切除术在原发性醛固酮增多症中的作用，同时强调了手术干预的生理影响，并将其与原发性醛固酮增多症的其他靶向药物治疗进行了比较。我们特别回顾了治疗性肾上腺切除术对单侧原发性醛固酮增多症的作用，非治疗性肾上腺切除术对双侧原发性醛固酮增多症的作用，以及这些干预措施如何影响与原发性醛固酮增多症医学治疗相关的生化和临床结果。
Primary aldosteronism is common and contributes to adverse cardiovascular, kidney, and metabolic outcomes. When instituted early and effectively, targeted therapies can mitigate these adverse outcomes. Surgical adrenalectomy is among the most effective treatments because it has the potential to cure, or attenuate the severity of, pathologic aldosterone excess, resulting in a host of biochemical and clinical changes that improve health outcomes. Herein, we review the role of surgical adrenalectomy in primary aldosteronism while emphasizing the physiologic ramifications of surgical intervention, and compare these to other targeted medical therapies for primary aldosteronism. We specifically review the role of curative adrenalectomy for unilateral primary aldosteronism, the role of non-curative adrenalectomy for bilateral primary aldosteronism, and how these interventions influence biochemical and clinical outcomes in relation to medical therapies for primary aldosteronism.