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病例介绍患者,男,44岁。因“发现血压升高1+年,肾上腺结节6个月”入院。1年前患者体检时发现血压240/170 mm Hg(1 mm Hg=0.133 k Pa)。予以四联降压药治疗,血压维持在160~180/110~120 mm Hg。6个月前患者因咽喉部手术行腹部CT检查发现双侧肾上腺多发结节,遂来我科就诊。体格检查:血压186/136 mm Hg,腰围98 cm,体质量指数27.4 kg/m~2,腹型肥胖,无满月脸、水牛背,皮肤未见紫纹。辅助检查:血钾2.94 mmol/L,晨8时血皮质醇636.0 nmol/L(参考值147.3~609.3 nmol/L),促肾
Case description Patient, male, 44 years old. Because “found blood pressure increased 1 + years, adrenal nodules 6 months ” admission. One year ago he was found to have blood pressure 240/170 mm Hg (1 mm Hg = 0.133 kPa) at physical examination. To quadruple antihypertensive drug treatment, blood pressure was maintained at 160 ~ 180/110 ~ 120 mm Hg. 6 months ago due to throat surgery in patients with abdominal CT examination found multiple adrenal nodules, then to our department. Physical examination: blood pressure 186/136 mm Hg, waist circumference 98 cm, body mass index 27.4 kg / m ~ 2, abdominal obesity, no full moon face, buffalo back, no purple pattern on the skin. Auxiliary examination: serum potassium 2.94 mmol / L, morning 8:00 Cortisol 636.0 nmol / L (reference value 147.3 ~ 609.3 nmol / L), promote kidney