Metyrosine and pheochromocytoma.
Metyrosine and pheochromocytoma.
复制标题
甲酪氨酸和嗜铬细胞瘤。
DOI：
10.1001/archinte.1997.00440290087009
复制
发表时间：
1997
影响因子：
--
通讯作者：
Bransome Ed
中科院分区：
文献类型：
--
作者：
J. Steinsapir;Carr Aa;Prisant Lm;Bransome Ed
背景
BACKGROUND
Severe hemodynamic instability may occur during surgery for removal of pheochromocytoma, unless there is preoperative pharmacological treatment.
OBJECTIVE
To evaluate the effects of metyrosine (alpha-methyl-p-tyrosine), a catecholamine synthesis inhibitor, and alpha-blockade with prazosin or phenoxybenzamine on cardiovascular morbidity during surgery for pheochromocytoma.
METHODS
A retrospective analysis was made of patients followed up at the Medical College of Georgia, Augusta, during 28 years who received metyrosine and prazosin (n = 6), metyrosine and phenoxybenzamine alone (n = 14), phenoxybenzamine alone (n = 6), or no medication (n = 7) during 3 weeks before tumor removal. The percentage of patients not requiring pressors or phentolamine during the intraoperative period as well as the perioperative peak systolic pressures and peak heart rates were estimated in each group.
RESULTS
There was a significant (P < .05) increase in intraoperative peak systolic pressures without preoperative treatment (mean +/- SD, 243 +/- 40 mm Hg) vs metyrosine (mean +/- SD, 168 +/- 27 mm Hg). Ninety-five percent of patients who received metyrosine did not require pressors intraoperatively vs 50% with phenoxybenzamine alone. Eighty-one percent of patients pretreated with metyrosine did not require intraoperative phentolamine vs 33% with phenoxybenzamine alone and 29% without medications. Two patients in the no medication group died as a results of hypertensive crisis.
CONCLUSIONS
The combination of alpha-metyrosine and alpha-blockade results in better blood pressure control and less need for use of antihypertensive medication or pressors during surgery, compared with the classical method of single-agent adrenergic blockade. Preoperative treatment with metyrosine along with an alpha-blocker is a useful strategy for decreasing the surgical morbidity in patients with pheochromocytoma and assumes greater importance as long as the availability of phentolamine for intraoperative use is a problem.
嗜铬细胞瘤和副神经节瘤：MR 成像与 CT 和 I-131 MIBG 闪烁扫描的比较。
影响因子：
19.7
作者：
Quint,LE;Glazer,GM;Francis,IR;Shapiro,B;Chenevert,TL
通讯作者：
Chenevert,TL