24小时尿香草扁桃酸、肾上腺素、去甲肾上腺素、多巴胺检测在嗜铬细胞瘤临床诊断中应用价值的比较研究

A Comparative Study on the Application Value of Urine VMA,E,NE and DA in the Clinical Diagnosis of Pheochromocytoma

目的探索尿香草扁桃酸(vanillymandelic acid,VMA)和尿肾上腺素(epinephrine,E)、去甲肾上腺素(norepinephrine,NE)、多巴胺(dopamine,DA)等在嗜铬细胞瘤患者尿液中代谢的一般规律及评估其作为嗜铬细胞瘤辅助诊断指标的应用价值。方法收集2017年1～5月由我院收治的214例肾上腺疾病患者的24小时尿液样本,分别检测尿液样本中VMA、E、NE、DA指标的含量。结果嗜铬细胞瘤组尿VMA和尿E、NE、DA水平显著高于其它肾上腺疾病组(P<0.05)。VMA在嗜铬细胞瘤诊断中的ROC曲线下面积为0.857,灵敏度为78.9%,特异性为92.6%,显著优于E、NE、DA这三个指标的诊断效能,与E+DA+VMA联合检测的诊断效能差异无统计学差异。结论 24h尿VMA检测结果可以作为辅助诊断嗜铬细胞瘤的潜在指标。

Objective To explore the mechanisms of the secretion of vanillymandelic acid,epinephrine,norepinephrine,and dopamine in urine of the patients with pheochromocytoma,and evaluate the application values of these substances as auxiliary diagnosis markers of pheochromocytoma. Methods We collected the 24-hour urine samples of 214 patients with adrenal diseases treated in our hospital during the first five months of 2017.The levels of vanillymandelic acid,epinephrine,norepinephrine and dopamine were detected in urine samples,respectively.The functions of these diagnostic indicators were analyzed statistically. Results The levels of urinary VMA and urinary E,NE and DA in pheochromocytoma were significantly higher than those of other adrenal diseases( P <0.05).The area under the ROC curve of VMA in the diagnosis of pheochromocytoma was 0.857,with the sensitivity 78.9%,and the specificity 92.6%.The diagnostic performance of VMA was significantly better than those of E,NE,DA,and not significantly different from the joint test of E+DA+VMA. Conclusion The results of 24-hour urinary VMA can be used as a potential marker for the diagnosis of pheochromocytoma.