嗜铬细胞瘤患者的颈动脉血管重塑

Carotid vascular remodeling in patients with pheochromocytoma.

作者信息

Bernini Giampaolo, Franzoni Ferdinando, Galetta Fabio, Moretti Angelica, Taurino Chiara, Bardini Michele, Santoro Gino, Ghiadoni Lorenzo, Bernini Matteo, Salvetti Antonio

机构信息

Department of Internal Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.

出版信息

J Clin Endocrinol Metab. 2006 May;91(5):1754-60. doi: 10.1210/jc.2005-2199. Epub 2006 Feb 21.

DOI:10.1210/jc.2005-2199

PMID:16492700

Abstract

CONTEXT

The influence of catecholamines on vascular remodeling in humans was investigated.

OBJECTIVE

The objective was to study the carotid vascular wall in patients with pheochromocytoma (PHEO).

DESIGN AND SETTING

An observational study was conducted in a university referral center for blood pressure diseases.

PATIENTS

Fourteen patients with PHEO, 15 matched high-normal essential hypertensives, 15 mild essential hypertensives, and 15 controls underwent two-dimensional conventional ultrasonography and ultrasonic tissue characterization of the carotid wall.

MAIN OUTCOME MEASURES

Intimal media thickness (IMT), diameter, and corrected ultrasonic integrated backscatter signal (C-IBS) of carotid arteries were evaluated.

RESULTS

IMT in PHEOs (0.844 +/- 0.18 mm, mean +/- sd) was greater than not only controls (0.596 +/- 0.09 mm, P < 0.0002) but also high-normal (0.710 +/- 0.17 mm, P < 0.03), and even mild (0.727 +/- 0.20 mm, P = 0.06) hypertensives. IMT in the latter was higher than in controls (P < 0.03), without difference in comparison with high-normal hypertensives. C-IBS values in PHEOs (-21.71 +/- 2.0 dB, mean +/- sd) were greater than in controls (-26.20 +/- 1.73 dB, P < 0.0001) but also than in high-normal (-23.84 +/- 1.16 dB, P < 0.002) and mild (-23.37 +/- 1.99 dB, P < 0.01) hypertensives. C-IBS values in controls were lower than in high-normal (P < 0.0005) and mild (P < 0.0001) hypertensives. Carotid diameter was not significantly different in the four groups. In PHEOs, C-IBS was associated with urinary noradrenaline (r = 0.640, P < 0.01) and normethanephrine (r = 0.737, P < 0.009).

CONCLUSIONS

Carotid IMT of PHEOs is higher than in controls and matched groups of hypertensives with comparable or even higher blood pressure. This vascular rearrangement is characterized by increased IBS values due to collagen deposition and vascular fibrosis. Therefore, our data show that abnormal catecholamine levels take part per se in carotid wall remodeling of patients with PHEO.

摘要

背景

研究了儿茶酚胺对人体血管重塑的影响。

目的

研究嗜铬细胞瘤（PHEO）患者的颈动脉血管壁。

设计与地点

在一所大学的高血压疾病转诊中心进行了一项观察性研究。

患者

14例PHEO患者、15例匹配的高正常血压原发性高血压患者、15例轻度原发性高血压患者和15例对照者接受了颈动脉壁的二维传统超声检查和超声组织特征分析。

主要观察指标

评估颈动脉的内膜中层厚度（IMT）、直径和校正后的超声综合背向散射信号（C-IBS）。

结果

PHEO患者的IMT（0.844±0.18mm，均值±标准差）不仅大于对照组（0.596±0.09mm，P<0.0002），还大于高正常血压组（0.710±0.17mm，P<0.03），甚至大于轻度高血压组（0.727±0.20mm，P=0.06）。后两组的IMT高于对照组（P<0.03），与高正常血压组相比无差异。PHEO患者的C-IBS值（-21.71±2.0dB，均值±标准差）大于对照组（-26.20±1.73dB，P<0.0001），也大于高正常血压组（-23.84±1.16dB，P<0.002）和轻度高血压组（-23.37±1.99dB，P<0.01）。对照组的C-IBS值低于高正常血压组（P<0.0005）和轻度高血压组（P<0.0001）。四组的颈动脉直径无显著差异。在PHEO患者中，C-IBS与尿去甲肾上腺素（r=0.640，P<0.01）和去甲变肾上腺素（r=0.737，P<0.009）相关。