【摘要】 目的评价血浆游离3甲氧基去甲肾上腺素(NMN)和3甲氧基肾上腺素(MN)诊断嗜铬细胞瘤的意义。方法选择2005-03-2012-06河南省人民医院高血压科有嗜铬细胞瘤筛查指征的患者,酶联免疫方法检测并比较嗜铬细胞瘤(n=67)和非嗜铬细胞瘤患者(n=101)以及嗜铬细胞瘤患者手术前后NMN、MN水平,受试者工作特征(ROC)曲线评价血浆NMN和MN诊断嗜铬细胞瘤的敏感度和特异性。结果 NMN和MN的ROC曲线下面积分别为(0.999±0.001)和(0.789±0.073);嗜铬细胞瘤患者血浆NMN[(2331.546±1475.966)比(49.796±35.701)ng/L]和MN水平[(521.504±813.693)比(36.784±24.063)ng/L]高于非嗜铬细胞瘤患者(均P<0.01);血浆NMN在234.460ng/L时诊断嗜铬细胞瘤的敏感性和特异性分别为98.5%和100%,血浆MN在93.705ng/L时诊断嗜铬细胞瘤的敏感性和特异性分别为50.7%和100%。29例嗜铬细胞瘤患者手术后NMN[(81.780±53.087)比(2790.001±1451.237)ng/L]和MN[(35.986±23.344)比(496.810±764.574)ng/L]水平下降(均P<0.05)。结论测定血浆NMN和MN水平可做为筛查嗜铬细胞瘤的首选方法,酶联免疫方法测定NMN、MN简单有效。更多还原

【Abstract】 Objective To evaluate the significance of plasma free normetanephrine(NMN)and metanephrine(MN) in diagnosis of pheochromocytoma. Methods From March 2005to June 2012,the patients charactered with pheochromocytoma screening indications were selected from Hypertension Department of People’s Hospital of Henan Province. Plasma NMN and MN levels,detected by enzyme immunoassay(EIA),in pheochromocytoma patients(n=67)and non-pheochromocytoma cases(n=101)were compared as well as those in pheochromocytoma patients before and after the operation. Receiver operating characteristic(ROC)curves were employed to determine the sensitivity and specificity of plasma NMN and MN in the diagnosis of pheochromocytoma. Results The area under ROC curve of NMN was(0.999±0.001),and that of MN was(0.789±0.073). The NMN and MN levels of pheochromocytoma patients were higher than those of non-pheochromocytoma patients[NMN:(2331.546± 1475.966)vs(49.796±35.701)ng/L,MN(521.504±813.693)vs(36.784±24.063)ng/L,respectively,P< 0.01]. The sensitivity and specificity for the diagnosis of pheochromocytoma were 98.5% and 100% respectively when plasma NMN concentration was 234.460ng/L,and which were 50.7% and 100% respectively when plasma MN was at the level of 93.705ng/L. 29pheochromocytoma subjects showed decreased plasma NMN and MN levels after the operation as compared with before the operation[NMN(81.780±53.087)vs(2790.001±1451.237) ng/L;MN(35.986±23.344)vs(496.810±764.574)ng/L,both P<0.05]. Conclusions Determinations of plasma NMN and MN levels can be adopted as the preferred method for screening pheochromocytoma. And EIA is an effective and simple way for plasma NMN and MN detection.更多还原