基础医学与临床 ›› 2009, Vol. 29 ›› Issue (7): 753-756.

• 临床园地 • 上一篇    下一篇

亚临床嗜铬细胞瘤的诊治

童安莉 曾正陪 李明 陈适 卢琳 杨堤 李汉忠   

  1. 中国医学科学院北京协和医学院北京协和医院内分泌科 中国医学科学院 北京协和医学院 北京协和医院泌尿外科
  • 收稿日期:2008-12-25 修回日期:2009-03-27 出版日期:2009-07-20 发布日期:2009-07-20

Diagnosis and Treatment of Subclinical Pheochromocytoma

An-li TONG, Zheng-pei ZENG, Ming LI, Shi CHEN, Lin LU, Di YANG, Han-zhong LI   

  1. Department of Endocrinology, Key laboratory of Ministry of Health, PUMC Hospital, CAMS & PUMC Dept. of Urology, PUMC Hospital, CAMS & PUMC
  • Received:2008-12-25 Revised:2009-03-27 Online:2009-07-20 Published:2009-07-20

摘要: 目的 分析亚临床嗜铬细胞瘤(PHEO)的临床特点。方法 回顾性总结并分析北京协和医院1997年~2007年收治的22例亚临床PHEO的病例资料。 结果 患者均无明显临床症状,测定24h尿儿茶酚胺正常10例,增高12例。16例患者用α受体阻滞剂进行术前准备,手术中切瘤前挤压瘤体患者血压升高的最高值、切瘤后血压下降的最低值及术中血压波动差值分别为163±34/86±20 mmHg,105±12/61±10 mmHg及58±37/25±21 mmHg;而6例未药物准备的患者上述指标分别为169±36/104±20 mmHg, 97±18/56±13 mmHg,71±48/48±29 mmHg,切瘤前DBP最高值和术中DBP波动值前者比后者均明显减少(均P<0.05)。结论 大部分亚临床PHEO患者尿儿茶酚胺升高,并且术中血压波动较大,对患者用α受体阻滞剂进行术前准备非常必要,可以减少手术风险。

关键词: 亚临床嗜铬细胞瘤, 诊断, 治疗

Abstract: Objective To analyze the clinical features of patients with subclinical pheochromocytoma (PHEO). Methods Review of clinical features of 22 patients with subclinical PHEO treated in PUMC hospital from 1997 to 2007. Results All patients were asymptomatic. 24hrs urinary catecholamine excretion was detected normal in 10 of 22 cases, while increased in the others. 16 patients were prepared withα-receptor blocker before operation. During the operation, BPmax (maximal blood pressure) before tumor resection, BPmin (minimal blood pressure) after resection and ΔBP(BPmax-BPmin) were 163±34/86±20 mmHg,105±12/61 ±10 mmHg and 58±37/25±21 mmHg, Respectively, in the prepared group. And they were 169±36/104±20 mmHg, 97±18/56±13 mmHg and 71±48/48±29 mmHg in the other 6 cases without α- blocker preparation. DBPmax and ΔDBP in the prepared group were significantly lower than the unprepared group. Conclusions Most patients with subclinical PHEO have increased catecholamine secretion. Blood pressure is fluctuant greatly during operation in some patients. Patients should be treated with α-receptor blocker preoperatively in order to decrease the operation risk.

Key words: subclinical pheochromocytomas, diagnosis, treatment

中图分类号: