Ross G A, Newbould E C, Thomas J, Bouloux P M, Besser G M, Perrett D, Grossman A
Department of Endocrinology, St Bartholomew's Hospital Medical College, West Smithfield, London, UK.
Ann Clin Biochem. 1993 Jan;30 ( Pt 1):38-44. doi: 10.1177/000456329303000107.
Using a single HPLC-ECD methodology, plasma catecholamine data were compiled from 545 patients and 144 healthy subjects, and 24 h urinary free catecholamine data from 106 patients. From these data, normal reference ranges were derived for the clinical investigation of suspected phaeochromocytomas, specifically to address the question as to when a result is normal and when further investigation may be required. We have shown that noradrenaline and adrenaline concentrations in plasma and urine are not normally distributed, and basal plasma noradrenaline is significantly lower in normal volunteers than in hospital patients. We have also demonstrated that a reference range which does not take account of these factors will give a significant number of false-positive results. Age and sex did not appear to be significant variables for either plasma or urinary catecholamines. In the investigation of phaeochromocytoma, 95% confidence limits may be used as a warning to repeat sampling and 99% confidence limits as rendering the diagnosis extremely probable. In patients with phaeochromocytomas, urinary catecholamines had a 99.5% specificity and 100% sensitivity in the diagnosis, and thus provide for a rapid and efficient diagnostic screen.
采用单一的高效液相色谱-电化学检测法，收集了545例患者和144名健康受试者的血浆儿茶酚胺数据，以及106例患者的24小时尿游离儿茶酚胺数据。从这些数据中得出正常参考范围，用于疑似嗜铬细胞瘤的临床研究，特别是解决结果何时正常以及何时可能需要进一步检查的问题。我们已经表明，血浆和尿液中的去甲肾上腺素和肾上腺素浓度呈非正态分布，正常志愿者的基础血浆去甲肾上腺素显著低于住院患者。我们还证明，不考虑这些因素的参考范围会产生大量假阳性结果。年龄和性别对于血浆或尿儿茶酚胺似乎不是显著变量。在嗜铬细胞瘤的检查中，95%置信限可作为重复采样的警示，99%置信限则使诊断极有可能成立。在嗜铬细胞瘤患者中，尿儿茶酚胺在诊断中的特异性为99.5%，敏感性为100%，因此可提供快速有效的诊断筛查。
