嗜铬细胞瘤合并肾动脉狭窄

Coexisting Adrenal Pheochromocytoma and Renal Artery Stenosis

［目的］探讨嗜铬细胞瘤合并肾动脉狭窄的发病机制、肾血管造影的表现，与儿茶酚胺、肾素的关系及对肾血管的作用。［方法］分析个案报告和复习文献。［结果］患者为左肾上腺嗜铬细胞瘤合并双侧肾动脉狭窄，恶性高血压，２４小时尿儿茶酚胺升高，切除肿瘤后血压下降但未降至正常。［结论］本病的发病机制可能为肿瘤压迫或纤维粘连合并儿茶酚胺过度分泌引起的肾动脉可逆或不可逆性狭窄。由于引起肾动脉狭窄的病因不同，血管造影可有不同的表现。与儿茶酚胺的过度分泌及肾动脉狭窄对高血压有不同的致病作用。

Purpose] To explore the etiology of the coexisting adrenal phechromocytoma and renal artery stenosis, the appearance of the renal angiogram and the interrelationship between catecholamine, renin and their effect on renal vasculature. [Method] A case report and literatureview. [Results] The patient suffered from left adrenal pheochromocytoma associated with bilateral renal artery stenosis, severe hypertension, and elevation of 24 hour urinary catecholamine. Post - operation she remained hypertension. [Conclusion] Coexisting pheochromocytoma and renal artery stenosis may be caused by tumor compression or reversible or irreversible renal artery stenosis due to high catecholamine concentration. Renal angiogram has different appearance because of pathogenic variety. High catecholamine level and renal artery stenosis may be the pathogenic factors.