3 　PA治疗进展 
        APA患者和PAH患者大部分可通过肾上腺腺瘤切除或部分切除手术获得治愈。长期追踪观察表明年轻、病程短者预后更好。近年来发展的腹腔镜手术使患者得到更快的恢复手术并发症较开腹手术明显减少缩短了平均住院日。BAH的主要治疗方法为药物治疗手术治疗效果差。药物主要为醛固酮受体竞争性抑制剂螺内酯(安体舒通) 在临床上我们常常行安体舒通试验性治疗每日320 ～400mg历时1～2周若高血压、低血缓解进一步证实PA的诊断。安体舒通在降低PA患者血压的同时还能改善由于高醛固酮血症对心肌和血管的毒性降低心力衰竭和心肌梗死发生率此作用是独立于降压作用之外。安体舒通治疗有一定的不良反应主要是由于对孕酮和雄激素受体的部分拮抗作用临床上可表现为男性乳房发育、阳痿、性欲减退女性月经紊乱。近来依普利酮( ep lerenone)由于其选择性作用于醛固酮受体而避免了上述不良反应[ 26 ]。

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