Plouin P F, Degoulet P, Tugayé A, Ducrocq M B, Ménard J
Nouv Presse Med. 1981 Mar 7;10(11):869-72.
In an attempt to find out whether phaeochromocytoma could be screened by questioning, the authors have recorded in a population of 2585 hypertensive patients the symptoms known to be most frequently associated with the tumour, i.e. headaches, palpitations and sweating attacks. Since 72.4% of the entire population reported one or another of these complaints, no single symptom could be taken as suggestive of phaeochromocytoma. However, only 6.5% of the patients reported all three symptoms and could therefore be considered as forming a subgroup likely to have the tumour. Patients in this subgroup differed from the others in the predominance of females (p less than 0.01), the higher frequency of anxiety (p less than 0.01) and above all, the higher incidence of phaeochromocytoma (5.9% as against 0.04%; p less than 0.01). The symptomatic triad (headaches, palpitations, sweating attacks) has a specificity of 93.8%, a sensitivity of 90.9% and an exclusion value of 99.9% for the diagnosis of phaeochromocytoma. Its presence in hypertensive patients justifies systematic assays of blood or urinary catecholamines. In its absence, the probability of phaeochromocytoma is inferior to 1 in 1 000.
为了弄清楚是否可以通过问诊来筛查嗜铬细胞瘤，作者在2585名高血压患者群体中记录了已知与该肿瘤最常相关的症状，即头痛、心悸和出汗发作。由于整个人口中72.4%的人报告了这些症状中的一种或另一种，因此没有单一症状可被视为嗜铬细胞瘤的提示症状。然而，只有6.5%的患者报告了所有三种症状，因此可被视为可能患有该肿瘤的一个亚组。该亚组患者与其他患者的不同之处在于女性占主导（p小于0.01）、焦虑频率较高（p小于0.01），最重要的是，嗜铬细胞瘤的发病率较高（5.9%对0.04%；p小于0.01）。症状三联征（头痛、心悸、出汗发作）对嗜铬细胞瘤诊断的特异性为93.8%，敏感性为90.9%，排除值为99.9%。其在高血压患者中的出现证明了对血液或尿液儿茶酚胺进行系统检测的合理性。若不存在该三联征，嗜铬细胞瘤的概率低于千分之一。
