Tonkin A L, Frewin D B, Russell W J, Jonsson J R
Department of Clinical and Experimental Pharmacology, University of Adelaide, Australia.
Clin Auton Res. 1994 Aug;4(4):167-73. doi: 10.1007/BF01826182.
The aim of this study was to assess the relationship between changes in plasma catecholamine concentrations and intra-arterial blood pressure (BP) measured simultaneously during resection of phaeochromocytoma (n = 14). Arterial plasma concentrations of noradrenaline (NA), adrenaline (A) and dopamine (DA) were measured by a radio-enzymatic method. Arterial NA concentrations (pmol/ml; median and Wilcoxon 95% CI) were 71.8 (46,162) before induction of anaesthesia, 113.0 (79,231) after intubation, 375.0 (285,931) during tumour handling and 32.5 (18,88) following tumour removal. Simultaneous mean BP values (mmHg; Mean +/- SEM) were 119 +/- 8, 114 +/- 7, 159 +/- 7 (p = 0.0001) and 72 +/- 6 (p < 0.0001) respectively. At the time of tumour handling there was a weak correlation between plasma NA and A combined and mean BP (r = 0.583, p = 0.029) and a stronger correlation between log plasma NA and A combined and pulse pressure (r = 0.749, p = 0.008). The very large rises in plasma catecholamine concentrations and in BP are likely to have been causally related. Individual patients maintained a constant ratio of NA to A in plasma from pre-induction to tumour handling (r = 0.916, p < 0.0001). The maintenance of a constant NA:A ratio suggests that the pattern of catecholamine synthesis and release may be a characteristic of the individual tumour.
本研究旨在评估在14例嗜铬细胞瘤切除术期间，血浆儿茶酚胺浓度变化与同步测量的动脉血压（BP）之间的关系。采用放射酶法测定动脉血浆去甲肾上腺素（NA）、肾上腺素（A）和多巴胺（DA）的浓度。动脉NA浓度（pmol/ml；中位数和Wilcoxon 95%可信区间）在麻醉诱导前为71.8（46,162），插管后为113.0（79,231），肿瘤操作期间为375.0（285,931），肿瘤切除后为32.5（18,88）。同步平均BP值（mmHg；平均值±标准误）分别为119±8、114±7、159±7（p = 0.0001）和72±6（p < 0.0001）。在肿瘤操作时，血浆NA与A总和与平均BP之间存在弱相关性（r = 0.583，p = 0.029），而对数血浆NA与A总和与脉压之间存在更强的相关性（r = 我们749，p = 0.008）。血浆儿茶酚胺浓度和BP的大幅升高可能存在因果关系。从诱导前到肿瘤操作，个体患者血浆中NA与A的比例保持恒定（r = 0.916，p < 0.0001）。NA:A比例的恒定表明儿茶酚胺合成和释放模式可能是个体肿瘤的一个特征。
