特定年龄段儿童血浆游离去甲变肾上腺素、变肾上腺素、3-甲氧基酪胺和 3-O-甲基多巴的参考区间：对婴儿早期尤为重要。
Age-specific pediatric reference intervals for plasma free normetanephrine, metanephrine, 3-methoxytyramine and 3-O-methyldopa: Particular importance for early infancy.
机构信息
Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
出版信息
Clin Chim Acta. 2019 Jul;494:100-105. doi: 10.1016/j.cca.2019.03.1620. Epub 2019 Mar 20.
BACKGROUND
Availability of appropriately established reference intervals for biochemical tests can be troublesome in pediatrics. Here we establish age-specific continuous reference intervals for catecholamine O-methylated metabolites in children evaluated for catecholamine producing tumors, particularly younger children with suspected neuroblastoma.
METHODS
Plasma concentrations of 3-methoxytyramine, normetanephrine, metanephrine, and 3-O-methyldopa were analyzed by liquid chromatography tandem mass spectrometry in 533 children aged 2 days to 18 years.
RESULTS
Concentrations of plasma free normetanephrine, 3-methoxytyramine and 3-O-methyldopa were higher in neonates up until six months of age, but thereafter declined steeply to levels after one year that were <38% those of neonatal concentrations and to further lower concentrations in teenagers that were <23% those in neonates. In contrast, concentrations of plasma free metanephrine showed a reciprocal pattern with 50% lower concentrations in infants below one year compared to later in childhood.
CONCLUSION
The dynamic reciprocal changes in plasma concentrations of normetanephrine, 3-methoxytyramine and 3-O-methyldopa compared to metanephrine during early childhood suggest underlying developmental changes in extra-adrenal and adrenal chromaffin tissue that must be considered for pediatric reference intervals, particularly in infants. With such reference intervals at hand, biochemical testing for catecholamine producing tumors in young children is substantially improved.
背景
在儿科中，获得适当建立的生化测试参考区间可能会很麻烦。在这里，我们为评估儿茶酚胺产生肿瘤的儿童，特别是疑似神经母细胞瘤的年幼儿童，建立了儿茶酚胺 O-甲基化代谢物的特定年龄连续参考区间。
方法
通过液相色谱串联质谱法分析了 533 名年龄在 2 天至 18 岁的儿童的血浆 3-甲氧基酪胺、去甲变肾上腺素、变肾上腺素和 3-O-甲基多巴浓度。
结果
新生儿至 6 个月大时，血浆游离去甲变肾上腺素、3-甲氧基酪胺和 3-O-甲基多巴的浓度较高，但此后急剧下降至 1 岁后浓度为新生儿浓度的<38%，青少年浓度进一步下降至新生儿浓度的<23%。相比之下，血浆游离变肾上腺素的浓度呈相反模式，1 岁以下婴儿的浓度比儿童后期低 50%。
结论
与变肾上腺素相比，儿茶酚胺产生肿瘤的生化检测在儿童中得到了极大的改善。在儿童早期，去甲变肾上腺素、3-甲氧基酪胺和 3-O-甲基多巴的血浆浓度呈动态反向变化，提示肾上腺外和肾上腺嗜铬组织发生了发育变化，这在制定儿科参考区间时必须考虑到，尤其是在婴儿中。有了这些参考区间，就可以大大改善对幼儿儿茶酚胺产生肿瘤的生化检测。
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