嗜铬细胞瘤和副神经节瘤(PPGL)是罕见的肿瘤,和这些患者的动态血压监测(ABPM)数据以及阻断对ABPM参数的影响有限。我们的目标是在印度西部我们中心的一组PPGL中描述ABPM参数。
对有ABPM数据的PPGL患者进行回顾性研究。人口统计细节,分泌状态,并检索了ABPM数据。变异系数(CV)计算为以百分比计的标准偏差/平均值。
在纳入的39名患者中,演示时的平均年龄为39.3±14.2岁;20名(51.3%)为男性,25(64.1%)高血压,平均肿瘤直径为5.3cm。在18例基线ABPM没有药物治疗的患者中,那些夜间血压下降的人(6/18,33%)有更高的血清间肾上腺素(中位数313.2vs.34.7pg/ml,P=0.028)。尽管办公室血压(BP)正常,8.9%的收缩压血压读数>140mmHg,1.2%为>160mmHg。在29例ABPM阻滞前后的患者中,平均血压(收缩压121.6vs.132.5mmHg,P=0.014;舒张压68.9vs.76.4mmHg,P=0.005)和血压读数高于140mmHg的百分比(中位数9.4%与24.4%,P=0.016)在高血压(n=19)患者术前阻断后显著降低,而CV是相似的。氨氯地平或哌唑嗪阻断的患者的阻断后ABPM特征相似。
ABPM提供了有关PPGL中BP特性的其他信息。术前阻断可降低BP偏移的幅度,但不影响BP变异性。
UNASSIGNED: Pheochromocytoma and paraganglioma (PPGL) are rare tumors, and data on ambulatory blood pressure monitoring (ABPM) in these patients and the effect of
blocking on ABPM parameters is limited. We aimed to describe ABPM parameters in a cohort of PPGL at our center in western India.
METHODS: Retrospective study of patients with PPGL whose ABPM data was available. Demographic details, secretory status, and ABPM data were retrieved. Coefficient of variability (CV) was calculated as standard deviation/mean in percentage.
RESULTS: In the 39 included patients, mean age at presentation was 39.3 ± 14.2 yr; 20 (51.3%) were males, 25 (64.1%) hypertensive, and mean tumor diameter was 5.3 cm. In 18 patients whose baseline ABPM was done without medications, those with nocturnal blood pressure dipping (6/18, 33%) had higher serum metanephrines (median 313.2 vs. 34.7 pg/ml, P = 0.028). Despite normal office blood pressure (BP), 8.9% of systolic BP readings were >140 mmHg, and 1.2% were >160 mmHg. Among 29 patients with both pre and post-block ABPM, mean BP (systolic 121.6 vs. 132.5 mmHg, P = 0.014; diastolic 68.9 vs. 76.4 mmHg, P = 0.005) and percentage of BP readings above 140 mmHg (median 9.4% vs. 24.4%, P = 0.016) were significantly lowered after the preoperative blockade in hypertensive ( n = 19) patients, whereas CV was similar. The post-blockade ABPM characteristics were similar in patients blocked with amlodipine or prazosin.
CONCLUSIONS: ABPM provides additional information about BP characteristics in PPGL. The preoperative
blocking decreases the magnitude of BP excursions but does not affect BP variability.