儿茶酚胺症25例报告  

Diagnosis and treatment of catecholamine syndrome (report of 25 cases)

作　　者：张淳[1] 林炳森[1] 黎明[1] 

机构地区：[1]广东汕头大学医学院第二附属医院泌尿外科,广东汕头515041

出　　处：《现代泌尿外科杂志》2004年第3期167-168,共2页Journal of Modern Urology

摘　　要：目的　提高儿茶酚胺症的诊断和治疗水平。方法　回顾性分析我院自 1986年 6月至 2 0 0 3年 5月收治肾上腺嗜铬细胞瘤2 2例、肾上腺髓质增生症 3例的临床资料。临床表现为阵发性高血压 12例 (4 8% ) ,持续性高血压 11例 (4 4 % ) ,血压正常 2例(8% )。尿VMA检查阳性率 94 % (2 4 / 2 5 )。B超、CT、MRI阳性率分别为 88% (2 2 / 2 5 )、90 % (2 0 / 2 2 )、83% (5 / 6 )。结果　全部行手术治疗。随访 2 0例 ,血压正常无需药物控制 17例 (85 % ) ,2例肾上腺髓质增生和 1例肾上腺嗜铬细胞瘤仍需口服降压药控制血压。结论　尿VMA和B超、CT、MRI在定性及定位诊断中有重要价值。手术仍为主要的治疗手段。强调术前准备可减少和防止并发症的发生。Objective To evaluate the diagnosis and treatment of catecholamine syndrome. Methods A total of 25 cases of catecholamine syndrome diagnosed and treated between 1986 to 2003 were reviewed and studied. 92% of these cases manifested hypertension. Urinary VMA assay was specific and essential for diagnosis, the positive sensitivity being 94% (24/25). The accuracy rate of localization and diagnosis with B-ultrasonography, CT and MRI was 88% (22/25), 90% (20/22) and 83% (5/6), respectively, for catecholamine syndrome. Results All the 25 cases of catecholamine syndrome were comfired by surgery, and 20 cases was studied subsequently. In 17 of the 20, blood pressure was normal. In 3 cases (2 of adrenal medullary hyperplasia and 1 of adrenal pheochromocytoma) of the 20, blood pressure did not return to normal until oral administration of hypotensive. Conclusion Urinary VMA assay is specific and essential for diagnosis. The accuracy rate of localization and diagnosis is high with B-ultrasonography, CT and MRI. Surgical procedure is still the only means of treatment and meticulous preoperative preparations are essential.

关 键 词：儿茶酚胺症 尿VMA B超检查 CT检查 肾上腺嗜铬细胞瘤 肾上腺髓质增生症 手术治疗 

分 类 号：R586[医药卫生—内分泌]