肾上腺嗜铬细胞瘤患者皮质醇激素与儿茶酚胺激素分泌水平的相关性  

Correlation between cortisol and catecholamine in patients with pheochromocytoma

作　　者：成泽宇 曹晓明[2] 王一凯 CHENG Zeyu;CAO Xiaoming;WANG Yikai(The First Clinical Medical College of Shanxi Medical University,Taiyuan 030000;Department of Urology,The First Affiliated Hospital of Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学第一临床医学院,山西太原030000 [2]山西医科大学第一医院泌尿外科,山西太原030000 [3]山西医科大学,山西太原030000

出　　处：《现代泌尿外科杂志》2022年第4期319-323,共5页Journal of Modern Urology

摘　　要：目的探索嗜铬细胞瘤患者皮质醇激素分泌水平变化及其与儿茶酚胺类激素分泌之间的相关性。方法回顾性分析2017年6月-2020年6月就诊于山西医科大学第一医院泌尿外科的嗜铬细胞瘤患者以及同期的肾上腺醛固酮瘤和原发性高血压患者的资料,共纳入嗜铬细胞瘤患者37例、肾上腺醛固酮瘤患者92例、原发性高血压患者172例,以嗜铬细胞瘤组为基准组,利用倾向性评分对3组患者进行匹配,比较嗜铬细胞瘤组患者与另外两组患者的皮质醇激素水平以及嗜铬细胞瘤患者手术前后的皮质醇激素水平变化,采用斯皮尔曼相关系数评估嗜铬细胞瘤患者皮质醇激素与儿茶酚胺激素分泌水平的相关性。结果最终成功匹配93例,三组各31例,嗜铬细胞瘤组患者尿香草扁桃酸(VMA)含量显著高于醛固酮瘤组(P=0.002)和高血压组(P=0.004),24 h尿游离皮质醇显著高于醛固酮瘤组(P=0.009)和高血压组患者(P=0.034);肿瘤切除术后嗜铬细胞瘤患者尿VMA、血浆皮质醇浓度、尿17羟皮质类固醇(17-OHCS)和24 h尿游离皮质醇显著低于术前,差异均有统计学意义(P<0.05);嗜铬细胞瘤患者24 h尿游离皮质醇与血浆甲基肾上腺素(r_(s)=0.431,P=0.015)及与尿VMA呈正相关关系(r_(s)=0.374,P=0.038)。结论嗜铬细胞瘤患者体内皮质醇激素分泌增多,并且与儿茶酚胺类激素的过度分泌密切相关。Objective To explore the correlation between cortisol and catecholamine in patients with pheochromocytoma(PCC).Methods Clinical data of 37 patients with PCC,92 patients with adrenal aldosteronoma,and 172 patients with essen⁃tial hypertension treated during Jun.2017 and Jun.2020 were retrospectively analyzed.The PCC group served as the reference group,and the tendency score was used to match the three groups.The levels of corticosteroids were compared among the three groups,and the changes of corticosteroids in PCC patients before and after operation were compared.Spelman correlation coeffi⁃cient was used to evaluate the correlation between cortisol and catecholamine in PCC patients.Results A total of 93 patients were successfully matched,31 in each group.The level of urinary vanillic mandelic acid(VMA)in PCC group was significantly higher than that in aldosteronoma group(P=0.002)and hypertension group(P=0.004);the 24-hour urinary free cortisol in PCC group was significantly higher than that in aldosteronoma group(P=0.009)and hypertension group(P=0.034).After tu⁃mor resection,the level of urinary VMA,cortisol,urinary 17-hydroxycorticosteroid(17-OHCS)and 24-hour urinary free cor⁃tisol were significantly lower than those before operation(all P<0.05)in PCC group.The 24-hour urinary free cortisol was posi⁃tively correlated with plasma methylepinephrine(r_(s)=0.431,P=0.015)and urinary VMA(r_(s)=0.374,P=0.038)in PCC pa⁃tients.Conclusion The secretion of corticosteroids in PCC patients is increased,which is closely related to the excessive se⁃cretion of catecholamines.

关 键 词：肾上腺嗜铬细胞瘤 儿茶酚胺 皮质醇 

分 类 号：R736.6[医药卫生—肿瘤]