合并原发性醛固酮增多症的急性缺血性卒中患者临床分析

目的探讨合并原发性醛固酮增多症(PA)的急性缺血性卒中患者临床特点。方法收集19例确诊的合并PA的急性缺血性卒中患者临床资料,与同期就诊的384例未合并PA的急性缺血性卒中患者进行比较。结果合并PA的急性缺血性卒中患者相对于未合并PA的急性缺血性卒中患者入院时血压更高(收缩压P=0.012,舒张压P=0.009);合并PA的急性缺血性卒中患者相对于未合并PA的急性缺血性卒中患者血钾更低(P0.001),但仅有6例PA患者(31.6%)血钾低于正常值下线(3.5 mmol/L)。合并PA和未合并PA的急性缺血性卒中患者TOAST分型所占比例没有明显差异。结论急性缺血性卒中患者中合并PA的患者比例较高,应对入院时有持续性高血压或难治性高血压和合并低钾血症等PA危险因素的缺血性卒中患者进行筛查。

Clinical features of patients with acute ischemic stoke and primary aldosteronism

Objective To investigate the clinical features of patients with acute ischemic stroke and primary aldosteronism (PA).Methods A total of 403 patients with acute ischemic stroke were enrolled, and according to the presence or absence of PA, they were divided into PA group with 19 patients and non-PA group with 384 patients. Related clinical data were compared between the two groups.Results Compared with the non-PA group, the PA group had significantly higher systolic pressure and diastolic pressure on admission (P=0.012 and P=0.009) and a significantly lower serum potassium level (P<0.001), and only 6 patients in the PA group (31.6%) had a serum potassium level below the lower limit of normal (3.5 mmol/L). There was no significant difference between the two groups in the proportion of patients with each TOAST type.Conclusions There is a high prevalence rate of PA among patients with acute ischemic stroke. Screening should be performed for the patients with acute ischemic stroke who have the risk factors for PA such as sustained or refractory hypertension and hypokalemia.