Feldman J M, Klatt C
Clin Chim Acta. 1981 Dec 24;117(3):279-88. doi: 10.1016/0009-8981(81)90115-7.
With a radioenzymatic method of analysis we determined the concentration of plasma and platelet norepinephrine in simultaneously drawn blood samples from six patients with pheochromocytomas. All six subjects had elevated platelet norepinephrine concentrations in the preoperative or intraoperative period. Three of the six patients had a normal plasma norepinephrine concentration in their sample. After resection of benign pheochromocytomas the platelet and plasma norepinephrine of five patients returned to normal. The platelet and plasma norepinephrine concentration of a patient with a malignant, non-resectable pheochromocytoma remained elevated. Eight of 30 patients (27%) with hypertension, not thought to be due to pheochromocytoma, had elevated platelet norepinephrine concentrations, All 8 of these patients had diastolic blood pressures of 120 mm Hg or greater at the time the blood samples were drawn. In contrast, the six patients with pheochromocytomas had elevated platelet norepinephrine concentrations while normotensive. Only five of 60 "sick" patients (8%) without a history of hypertension had elevated platelet norepinephrine concentration. Platelet norepinephrine concentration is an excellent test to screen patients, with a history of spells of hypertension but presently normotensive, for pheochromocytomas. An elevated value should be followed up with measurement of vanillylmandelic acid (VMA) and/or catecholamines in a 24-h urine collection.
我们采用放射酶分析法测定了6例嗜铬细胞瘤患者同步采集的血样中血浆和血小板去甲肾上腺素的浓度。所有6例患者在术前或术中血小板去甲肾上腺素浓度均升高。6例患者中有3例血样中的血浆去甲肾上腺素浓度正常。良性嗜铬细胞瘤切除后，5例患者的血小板和血浆去甲肾上腺素恢复正常。1例恶性、不可切除的嗜铬细胞瘤患者的血小板和血浆去甲肾上腺素浓度仍升高。30例被认为并非由嗜铬细胞瘤引起高血压的患者中有8例（27%）血小板去甲肾上腺素浓度升高，所有这8例患者在采集血样时舒张压均在120 mmHg或更高。相比之下，6例嗜铬细胞瘤患者在血压正常时血小板去甲肾上腺素浓度就升高。60例无高血压病史的“患病”患者中只有5例（8%）血小板去甲肾上腺素浓度升高。血小板去甲肾上腺素浓度是一项很好的检测方法，可用于筛查有高血压发作史但目前血压正常的患者是否患有嗜铬细胞瘤。如果该值升高，应接着检测24小时尿香草扁桃酸（VMA）和/或儿茶酚胺。
