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嗜铬细胞瘤/副神经节瘤术前儿茶酚胺心肌病的药物治疗方案

樊华 张玉石 纪志刚 张学斌 李汉忠

樊华, 张玉石, 纪志刚, 张学斌, 李汉忠. 嗜铬细胞瘤/副神经节瘤术前儿茶酚胺心肌病的药物治疗方案[J]. 协和医学杂志, 2019, 10(4): 353-357. doi: 10.3969/j.issn.1674-9081.2019.04.008
引用本文: 樊华, 张玉石, 纪志刚, 张学斌, 李汉忠. 嗜铬细胞瘤/副神经节瘤术前儿茶酚胺心肌病的药物治疗方案[J]. 协和医学杂志, 2019, 10(4): 353-357. doi: 10.3969/j.issn.1674-9081.2019.04.008
Hua FAN, Yu-shi ZHANG, Zhi-gang JI, Xue-bin ZHANG, Han-zhong LI. Preoperative Medicine Treatment for Catecholamine-induced Cardiomyopathy in Patients with Pheochromocytoma/Paraganglioma[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(4): 353-357. doi: 10.3969/j.issn.1674-9081.2019.04.008
Citation: Hua FAN, Yu-shi ZHANG, Zhi-gang JI, Xue-bin ZHANG, Han-zhong LI. Preoperative Medicine Treatment for Catecholamine-induced Cardiomyopathy in Patients with Pheochromocytoma/Paraganglioma[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(4): 353-357. doi: 10.3969/j.issn.1674-9081.2019.04.008

嗜铬细胞瘤/副神经节瘤术前儿茶酚胺心肌病的药物治疗方案

doi: 10.3969/j.issn.1674-9081.2019.04.008
详细信息
    通讯作者:

    李汉忠电话:010-69156031, E-mail: pumchlihanzhong@yeah.net

  • 中图分类号: R699.3

Preoperative Medicine Treatment for Catecholamine-induced Cardiomyopathy in Patients with Pheochromocytoma/Paraganglioma

More Information
  • 摘要:   目的  总结嗜铬细胞瘤/副神经节瘤患者术前儿茶酚胺心肌病的药物调整方案,以期保证手术安全性。  方法  回顾性收集整理2007年1月至2019年1月在北京协和医院泌尿外科接受手术治疗的嗜铬细胞瘤/副神经节瘤伴儿茶酚胺心肌病患者的临床资料,包括临床表现、超声心动图检查结果、儿茶酚胺心肌病治疗方案及治疗前后血、尿儿茶酚胺及代谢物、心功能的改变,并分析去甲肾上腺素水平与儿茶酚胺心肌病严重程度的相关性。正态分布的定量资料结果以均数±标准差表示,组间比较采用配对t检验,P<0.05为差异有统计学意义。  结果  17例患者符合入选和排除标准,轻至中度心功能不全,左心室射血分数(left ventricular ejection fraction,LVEF)平均为(42.58±7.35)%,经药物治疗后所有患者心功能得到改善,LVEF较治疗前显著提高至(56.0±7.09)% (t=0.507,P=0.038)。高去甲肾上腺素组及低去甲肾上腺素组的LVEF分别为(43.11±5.79)%和(42.0±9.19)% (t=0.015,P=0.973),药物治疗后两组LVEF分别为(55.2±5.21)%和(56.87±9.07)% (t=-0.145,P=0.732),差异均无统计学意义。  结论  嗜铬细胞瘤/副神经节瘤伴儿茶酚胺心肌病患者经药物治疗可有效改善心功能,去甲肾上腺素水平与儿茶酚胺心肌病严重程度无关。
    利益冲突  无
  • 图  1  腹部增强CT横断面示单侧肾上腺嗜铬细胞瘤(箭头)

    图  2  腹部增强CT横断面示双侧肾上腺嗜铬细胞瘤(箭头)

    图  3  腹部增强CT横断面示腹膜后副节瘤(箭头)

    图  4  胸部CT平扫横断面示儿茶酚胺心肌病急性左心功能不全患者保留气管插管时双侧肺水肿

    图  5  胸部正位X线示儿茶酚胺心肌病患者急性左心功能不全致双侧肺水肿,左侧为著

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出版历程
  • 收稿日期:  2019-03-08
  • 刊出日期:  2019-07-30

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