副神经节瘤29例临床特征分析

A Retrospective Study on Clinical Features of Paraganglioma

目的分析副神经节瘤患者的临床特点,提高对此病的认识。方法选取1990—2013年我院诊断为副神经节瘤的患者29例,记录并分析其性别、病程长短、家族史、临床表现、实验室检查及肿瘤定位和影像检查。结果29例副神经节瘤患者中女18例(62.1%),男11例(37.9%);平均发病年龄(39.0±3.8)岁,平均病程(4.5±2.5)年。临床表现为头痛14例(48.3%),头晕11例(37.9%),心悸10例(34.5%),胸闷、出汗各6例(20.7%)、乏力、腹痛、腹部包块各5例(17.2%),呕吐3例(10.3%),面色苍白、抽搐、怕热各2例(6.9%),面色潮红、视物模糊、无痛血尿、腹泻各1例(3.4%)。血压增高者23例(79.3%),血压正常者6例(20.7%)。共16例患者检测了血儿茶酚胺水平,儿茶酚胺升高13例(81.2%),其中去甲肾上腺素升高11例(68.8%)、多巴胺升高8例(50.0%)、肾上腺素升高3例(18.8%),儿茶酚胺正常3例(18.8%)。18例(62.1%)肿瘤位于肾上腺,9例(31.1%)位于腹主动脉旁,1例(3.4%)位于纵隔,1例(3.4%)位于膀胱。肿瘤直径(4.0±1.4)cm。结论副神经节瘤的临床表现差异大,血压增高、去甲肾上腺素升高较多见,肾上腺以外的肿瘤所占比例较大。CT能发现副神经节瘤,但不能确定肿瘤的性质。

Objective To have a better understand of paraganglioma by reviewing the clinical characteristics of para- ganglioma patients. Methods From 1990 to 2012, a total of 29 patients were diagnosed with paraganglioma in People＇s Hospital Peking University. The sex, age, the length of the disease, family history, clinical symptoms, laboratory results, tumor loca- tion and image findings of the cases were recorded and analyzed. Results Among the 29 cases of paraganglioma, 18 cases were female （62. 1% ）, 11 cases （37.9%） were male; The average age of morbidity was （39.0 ± 3.8） years old and the mean length of the disease was （4.5 ± 2.5） years. Clinical symptoms of headache： 14 cases （48.3%）; dizziness： 11 cases （37.9%） ; palpitations： 10 cases （34. 5% ） ; chest tightness and sweating： 6 cases （20. 7% ）, respectively; fatigue, abdomi- nal pain and abdominal mass： 5 cases （ 17.2% ） , respectively; vomiting： 3 cases （ 10. 3% ） ; pale, convulsions and heat intol- erant： 2 cases （6. 9% ） , respectively; hot flashes, blurred vision, painless hematuria and diarrhea： 1 case （3.4%）, respec- tively; elevated blood pressure： 23 cases （79. 3% ） ; normal blood pressure： 6 cases （20. 7% ） . The blood eatecbolamine lev- els of a total of 16 patients were examined, increased catecholamine level： 13 cases （81.2%） , increased norepinephrine level： 11 cases （68.8%） ; increased dopamine level： 8 cases （50. 0% ） ; increased adrenaline level： 3 cases （18.8%） ; normal cat- echolamine level： 3 patients （18.8%） . Tumor location： 18 cases （62.1%） located in the adrenal gland, 9 cases （31.1%） located around the abdominal aorta, 1 case （3.4%） located in the mediastinum, 1 case （3.4%） located in the bladder. Tumor is （4. 0 ± 1.4 ） cm in diameter. Conclusion The clinical manifestations of paraganglioma differs greatly, elevated blood pres- sure and increased norepinephrine level are common. Extra - adrenal tumors were not uncommon. Paraganglioma can be detected by CT, but the nature of the tumor can not be diagnosed by CT.