60例嗜铬细胞瘤患者心血管损害临床表现特征分析

Clinical characteristics of cardiovascular lesions in 60 patients with pheochromocytoma

目的分析嗜铬细胞瘤(PCC)患者的心血管损害临床表现特征。方法回顾性分析2012年4月至2016年12月中国核工业北京四○一医院收治的60例嗜铬细胞瘤患者的临床资料。分析患者的一般资料,PCC的部位、性质和治疗情况,患者各种临床表现和临床指标水平和心电图检查结果,并比较不同临床表现、临床指标水平和检查结果中患者所占比例情况。结果 60例嗜铬细胞瘤中位于左右侧肾上腺分别为26和32例,位于双侧2例,其中恶性49例,良性11例。男性发病率高于女性。51例(85.00%)有高血压表现。27例(45.00%)有头痛、心悸、多汗三联征表现,头痛、心悸、多汗所占比例分别为61.67%、68.33%和60.00%。患者生化检查中出现心肌酶谱、甘油三酯、血糖和尿酸等指标升高的比例分别为26.67%、33.33%、38.33%和31.67%。在心电图检查中,窦性心动过速(41.67%)和左室高电压(26.33%)较为常见。结论心脏损害为嗜铬细胞瘤患者最为常见的并发症,且高血压及心律失常为嗜铬细胞瘤患者最为典型的临床表现,在临床工作中需要认真鉴别。

Objective To analyze the clinical manifestations of cardiovascular lesions in patients with pheochromocytoma(PCC)and to provide a theoretical basis for clinical treatment of pheochromocytoma.Methods From April 2012 to December 2016,a retrospective analysis of clinical data of 60 patients with pheochromocytoma treated in Beijing 401 hospital of Chinese nuclear industry were performed.The patients’general information,the location,nature and treatment of the PCC were analyzed.The patients’clinical manifestations,clinical index levels,and electrocardiogram examination results,as well as patient’s ratio in each group were analyzed.Results Among the 60 patients,PCCs were detected in left adrenal gland in 26 patients,right adrenal gland in 32 patients,and bilateral adrenal glands in 2 patients.Forty-nine patients were diagnosed benign pheochromocytoma,and the other 11 cases were malignant.The number of male patients was significantly higher than that of female patients.In the 60 patients of pheochromocytoma,51 patients(85.00%)had persistent hypertension,27 patients(45.00%)had the triad syndrome of headache,palpitations,and perspiration.Headaches,palpitations,and sweats were seen in 61.67%,68.33%,and 60.00%patients,respectively.The ratio of the cardiac enzymes,triglycerides,blood glucose and uric acid in the patient's biochemical tests were 26.67%,33.33%,38.33%,and 31.67%,respectively.In ECG,sinus tachycardia(41.67%)and left ventricular high voltage(26.33%)were more common.Conclusions Heart damage is the most common complication in patients with PCC,and hypertension and arrhythmia are the most typical clinical symptoms in the patients.Therefore,careful identification is needed in clinical practice.