妊娠合并原发性醛固酮增多症误诊1例

本文报道1例妊娠合并原发性醛固酮增多症病例,探讨其临床表现、发病机制及易误诊为妊娠期高血压综合征的原因,对此例患者的病因、临床表现、辅助检查、治疗方法和预后进行回顾性分析。此例患者症状主要表现为难治性高血压、低钾血症,蛋白尿,极易误诊为妊娠期高血压综合征。因此,对于妊娠期合并难治性高血压伴四肢乏力等症状,不能仅仅满足于妊娠期高血压综合征诊断,还应注意行电解质,肾脏CT及立卧位醛固酮系检查,以期将妊娠合并原发性醛固酮增多症患者的误诊、误治率降到最低。

A misdiagnosed case of pregnancy complicated primary aldosteronism

This thesis reports one case of pregnancy complicated primary aldosteronism by investigating the clinical manifestation and pathogenesis, then discusses the causation of misdiagnosing the case as pregnancy-induced hypertension. According to retrospective analysis of the pathogenesis, clinical manifestation, laboratory examinations, therapies and prognosis, it is found that the main symptoms of this case are： refractory hypertension, hypokalemia, weakness and proteinuria. The symptoms are very similar to the pregnancy-induced hypertension. Therefore, a case can＇t be simply diagnosed as pegnancy-induced hypertension according to the symptoms of pregnacy complicated refractory hypertension, limbs weakness etc. In order to cut down the incorrect treatments and disdiagnosis rate of pregnany complicated primary aldosteronism, eletrolyte test, renal CT and supine aldosterone systemic tests must be brought in.