CIRCULATING AND URINARY CATECHOLAMINES IN PHEOCHROMOCYTOMA - DIAGNOSTIC AND PATHOPHYSIOLOGIC IMPLICATIONS
CIRCULATING AND URINARY CATECHOLAMINES IN PHEOCHROMOCYTOMA - DIAGNOSTIC AND PATHOPHYSIOLOGIC IMPLICATIONS
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DOI：
10.1056/nejm197909273011302
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发表时间：
1979-01-01
影响因子：
158.5
通讯作者：
STEWART, BH
中科院分区：
文献类型：
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作者：
BRAVO, EL;TARAZI, RC;STEWART, BH
对 24 名已确诊肿瘤的患者和 40 名临床表现可疑但没有疾病证据的患者进行了三项用于诊断嗜铬细胞瘤的生化测试。静息、仰卧位血浆儿茶酚胺（通过放射酶测定）的测量比 24 小时尿香草扁桃酸 (VMA) 或变肾上腺素或两者都更有用。 23 名嗜铬细胞瘤患者中，只有 1 名血浆儿茶酚胺在非嗜铬细胞瘤患者的范围内，而尿 VMA 为 22 名患者中的 11 名，尿变肾上腺素为 22 名中的 5 名，两种代谢物为 22 名中的 3 名。这些研究重申了血浆儿茶酚胺在嗜铬细胞瘤诊断中的价值，并表明尿儿茶酚胺 代谢物的用处较小。动脉压高度与儿茶酚胺循环水平之间的相关性较差，表明嗜铬细胞瘤中动脉压的调节是复杂的。
Three biochemical tests for the diagnosis of pheochromocytoma were evaluated in 24 patients with proved tumors and 40 patients whose clinical picture was suspect but who had no evidence of the disease. Measurement of resting, supine plasma catecholamines (by radioenzymatic assay) was more useful than either 24 h urinary vanillylmandelic acid (VMA) or metanephrines or both. In only 1 of 23 patients with pheochromocytoma were plasma catecholamines within the range of those in patients without pheochromocytoma, as compared with urinary VMA in 11 of 22, urinary metanephrines in 5 of 22 and both metabolites in 3 of 22. These studies reaffirm the value of plasma catecholamines in the diagnosis of pheochromocytoma and indicate that urinary catecholamine metabolites are less useful. The poor correlation between the height of arterial pressure and circulating levels of catecholamines suggests that the regulation of arterial pressure in pheochromocytoma is complex.