血浆游离甲氧基肾上腺素水平在诊断嗜铬细胞瘤中的价值  

Diagnostic value of free plasma metanephrines for pheochromocytoma

作　　者：高云朝[1] 陆汉魁[1] 罗全勇[1] 陈立波[1] 丁颖[1] 朱瑞森[1] 

机构地区：[1]上海交通大学附属第六人民医院核医学科,200233

出　　处：《中华检验医学杂志》2009年第5期535-537,共3页Chinese Journal of Laboratory Medicine

摘　　要：目的探讨酶联免疫分析法（EIA）检测血浆游离甲氧基肾上腺素[3-甲氧基肾上腺素（MN）和3-甲氧基去甲肾上腺素（NM）]诊断嗜铬细胞瘤的价值。方法病理确诊的30例嗜铬细胞瘤患者和51例高血压患者，用EIA检测血浆MN和NM，结合^131Ⅰ-间碘苄胍（MIBG）全身扫描结果进行分析比较。结果嗜铬细胞瘤组30例患者全身扫描均呈阳性；高血压组中有15例接受全身扫描，结果均呈阴性；嗜铬细胞瘤组MN浓度的中位数为59．3ng／L，高于高血压组（中位数为33．7ng／L，Z=-2．440，P〈0．05）；2组NM浓度的中位数分别为652．0ng／L和36．3ng／L，显著高于高血压组（Z=-6．699，P〈0．001）；2项联合检测（任一或全部阳性）的敏感度、特异度和准确性分别为96．7％（29／30），86．3％（44／51）和90．1％（73／81），联合检测的准确性与全身扫描结果比较，差异无统计学意义（100．0％，P〉0．05）。结论EIA法检测血浆游离甲氧基肾上腺素对嗜铬细胞瘤具有较高的诊断效能，有可能替代高压液相层析法而成为该病诊断的首选方法。Objective To investigate the application value of free plasma metanephrines metanephrine（MN） and normetanephrine （NM） measured with enzyme immunoassay （EIA）, NM in diagnosis of pheochromocytoma. Methods Histologically confirmed pheochromocytomas （ n = 30 ） and control patients with hypertension （n =51 ） were enrolled in the study. Blood tests for free plasma metanephrines （MN and NM） were performed with a commercially available EIA kit and the results were compared with ^131Ⅰ-metaiodobenzyl gnanidine （MIBG） whole body scan findings. Results The whole body scan was positive in all pheochromocytoma patients and negative in 15 control patients with 100% accuracy. The median values in the 2 groups were 59.3 ng/L and 33.7 ng/L （ Z = - 2. 440, P 〈 0. 05 ） for MN, 652. 0 ng/L and 36. 3 ng/L （ Z = - 6. 699, P 〈 0. 001 ） for NM, with 96. 7% （29/30） sensitivity, 86. 3 % （ 44/51 ） specificity and 90. 1% （ 73/81 ） accuracy for their combination （ either or both positive）. There was no significantly statistical difference when compared with ^131Ⅰ-MIBG whole body scan findings （ 100. 0% ,P 〉 0. 05 ）. Conclusion The results show that the EIA method may be eligible as an alternative to HPLC for plasma metanephrines determination in the identification of pheochromocytoma.

关 键 词：肾上腺肿瘤 嗜铬细胞瘤 甲基福林 酶联免疫吸附测定 

分 类 号：R686[医药卫生—骨科学]