VMK kuaj kuaj (rau vanillylmandelic acid) tau sau ntau zaus. Cov tshuaj no feem ntau pom muaj nyob hauv cov zis nrog rau lwm cov tshuaj hormones uas tsim los tawm tsam kev ntxhov siab los ntawm cov qog adrenal. Raws li qee qhov kev soj ntsuam, hauv cov neeg mob qog nqaij hlav uas zais catecholamines, qib ntawm cov kua qaub no siab dua li qub.
Lub ntsiab lus ntawm vanillylmandelic acid yog tus cwj pwm los ntawm nws cov qauv. Nws yog cov khoom kawg ntawm kev sib pauv ntawm catecholamines - norepinephrine thiab adrenaline.
Catecholamines yog synthesized nyob rau hauv lub adrenal medulla, thiab lawv nkag mus rau hauv cov hlab ntsha yog ib tug natural tshuaj tiv thaiv ntawm lub cev rau lub hlwb thiab lub cev kev nyuaj siab (ntshai, excitement, luag). Norepinephrine thiab epinephrine yog neurotransmitters uas nqa impulses ntawm paj hlwb. Norepinephrine txhawb nqa vasoconstriction thiab yog li ua rau cov ntshav siab nce ntxiv, adrenaline ua rau lub plawv dhia thiab nce metabolic.tshuaj.
Kev nce hauv vanillylmandelic acid hauv cov zis lossis ntshav tau pom hauv qee cov qog uas tsim cov catecholamines ntau dhau (pheochromocytoma, neuroblastoma).
Cov kua qaub no muaj nyob hauv cov zis me me, uas ua rau muaj kev ntxhov siab ntau ntxiv. Pheochromocytoma, neuroblastoma thiab lwm yam kab mob neuroendocrine muaj peev xwm tsim tau ntau cov catecholamines, uas provokes ib qho kev nce hauv cov khoom metabolic.
Mechanism of formation of this substance
Vanillylmandelic acid yog tsim los ntawm norepinephrine thiab adrenaline tsis ncaj qha, tab sis los ntawm cov metabolites nruab nrab: metanephrine, dihydroxyphenylglycol thiab normetanephrine. Dihydroxyphenyl glycol yog tsim los ntawm norepinephrine nrog kev koom tes ntawm MAO enzyme, normetanephrine thiab metanephrine - los ntawm norepinephrine thiab adrenaline, raws li, nrog rau kev koom tes ntawm COMT enzyme.
Tshuaj Tseem Ceeb
Qhov tseem ceeb tshwj xeeb hauv kev kho mob kev kho mob tsuas yog muab ntau npaum li cas cov ntsiab lus ntawm vanillylmandelic acid nyob rau hauv cov zis, uas yuav qhia tau tias muaj pheochromocytoma. Txawm li cas los xij, muaj qhov ua tau ntawm kev kuaj pom tsis tseeb hauv cov kev ntxhov siab. Kev ntsuas ntawm metanephrine muab cov ntaub ntawv tseem ceeb tshaj plaws txog qhov tsis muaj lossis muaj cov kab mob no.
Pheochromocytoma
Pheochromocytoma yog ib qho kab mob neoplasm uas tsim adrenaline thiab norepinephrine. Cov qog no tshwm sim hauvhnub nyoog 30-50 xyoo. Nws yog feem ntau benign thiab tsis metastasize. Cov tsos mob ntawm pheochromocytoma yog tshwm sim los ntawm kev tso tawm ntau ntawm catecholamines rau hauv cov ntshav. Thiab yog li ntawd:
- nce siab hauv siab thiab cov teeb meem tshwm sim los ntawm tus mob no (kev ua haujlwm tsis zoo hauv lub plawv thiab lub hlwb, exacerbation ntawm angina pectoris);
- mob ntshav siab tsis teb zoo rau kev kho mob ib txwm;
- mob taub hau;
- mob siab;
- tawm hws ntau dhau.
Pheochromocytoma yog ib feem ntawm MEN syndrome (ntau qhov endocrine neoplasia, uas cov qog tshwm sim ib txhij hauv ntau lub cev endocrine).
Kev kho mob phais tso cai rau koj tshem tawm cov qog thiab cov tsos mob kom tiav.
Neuroblastoma
Neuroblastoma yog ib qho mob qog nqaij hlav thaum ntxov, feem ntau ua ntej 2 xyoos, 90% - ua ntej 5 xyoos. Muaj tsawg zaus, nws yuav yog congenital. Nws tshwm sim los ntawm cov paj hlwb primitive paj hlwb ntawm lub sympathetic system, nyob rau hauv lub plab kab noj hniav, nyob rau hauv lub qog adrenal, nyob rau hauv lub hauv siab kab noj hniav, nyob rau hauv lub caj dab los yog nyob rau hauv lub me me pelvis. Thaum lub sijhawm kuaj mob, hauv 2/3 ntawm cov neeg mob twb muaj metastases thiab germination nyob rau hauv lub cev nyob ze.
Cov tsos mob qog:
- qaug zog, qaug zog, tsis qab los noj mov, ua npaws, kev coj cwj pwm tsis zoo;
- ntshav qab zib;
- mob pob qij txha;
- edema.
Kev Tshawb Fawb Txog
Rau kev kuaj mob,tshuaj xyuas qib ntawm vanillylmandelic acid, zis los yog ntshav yog coj los tshuaj xyuas. Kev tshawb fawb cov zis niaj hnub muab cov txiaj ntsig zoo dua piv nrog kev kawm txog ntshav, vim nws tshem tawm cov kev hloov pauv niaj hnub hauv catecholamines.
Ob hnub ua ntej kev sim, koj tsis tuaj yeem noj zaub, txiv hmab txiv ntoo, cov khoom uas muaj vanilla qab zib, cheese, chocolate, haus kas fes, tshuaj yej, npias. Cov tshuaj hauv qab no raug tso tseg: sulfonamides (etazol, streptocid, biseptol), diuretics, acelitsalicyric acid, methyldop, iodine npaj. Kev kuaj X-ray, siv cov tshuaj radiopaque thiab haus luam yeeb yog txwv tsis pub.
Qhov kev kuaj pom zoo thiab qhov nce ntxiv ntawm vanillylmandelic acid yuav tsum tau lees paub los ntawm kev pom cov qog lossis txiav txim ncaj qha ntawm cov ntsiab lus ntawm catecholamines hauv cov zis.
yam cuam tshuam rau qhov tshwm sim
Tsis ua raws li qhov yuav tsum tau ua rau urinalysis rau vanillylmandelic acid, ntim cov ntim tsis raug thiab xa mus rau qhov chaw kuaj tsis raws sijhawm tuaj yeem cuam tshuam cov txiaj ntsig.
Yam uas ua rau nce qib ntawm cov tshuaj hauv cov ntshav:
- kev nyuaj siab;
- kev ua lub cev;
- tshuaj thiab tshuaj: Aymalin, Glucagon, Epinephrine, Guanethidine (hauv thawj koob tshuaj), Levodopa (me ntsis nce), insulin (tom qab koob tshuaj ntau lossis insulin poob siab), tshuaj lithium, rauwolfia alkaloids, "Nitroglycerin",Aspirin, Clofibrate (nyob ntawm ntau npaum li cas), Labetolol, Methyldopa, Nalidixic Acid, Guaiacol, Phenazopyridine, Oxytetracycline;
- food: bananas, kas fes, chocolate, tshuaj yej.
Yam uas txo cov kua qaub:
- YChlorpromazine;
- "Debrikzovin";
- "Clofibrate" (kev cuam tshuam nyob ntawm qhov ntau npaum);
- YDisulfiram;
- Yhydrazine derivatives;
- "Guanethidine";
- Imipramine
- "Morphine";
- MAO inhibitors.
Research objectives
Lub hom phiaj tseem ceeb ntawm kev tshuaj xyuas rau vanillylmandelic acid yog txhawm rau txhim kho kev kuaj mob ntawm neuroblastoma, pheochromocytoma thiab ganglioneuroma. Lub xeev ua haujlwm ntawm adrenal cortex kuj raug soj ntsuam.
Kev tsis sib haum los ntawm tus qauv
Qib ntawm vanillylmandelic acid nyob rau hauv cov zis yog pom nyob rau hauv cov qog uas secrete catecholamines. Cov kev tshawb fawb soj ntsuam tau pom zoo kom kuaj xyuas thiab txiav txim tawm pheochromocytoma, suav nrog kev kawm txog kev tso zis ntawm homovanillic acid. Nyob rau hauv rooj plaub uas qhov kev kuaj mob ntawm pheochromocytoma yog dhau qhov tsis ntseeg, tus neeg mob yuav tsum raug cais tawm ntawm MEN, feem ntau cuam tshuam nrog pheochromocytoma (tus kab mob no kuj yuav tsum tau txiav txim tawm hauv tsev neeg ntawm tus neeg mob uas tau lees paub pheochromocytoma).
Reference values
Cov txiaj ntsig no nyob hauv:
- menyuam mos txog li 10 hnub ntawm lub neej - 1-5, 05 mg / hnub;
- menyuam yaus los ntawm 10 hnub rau 1 xyoos - tsawg dua 2.0mg/day;
- Cov menyuam yaus hnub nyoog 1 txog 18 xyoo qis dua 5.0 mg / hnub;
- adults - 2, 1-7, 6 mg/day.
Peb tau tshuaj xyuas seb qhov kev txiav txim siab ntawm vanillylmandelic acid hauv cov zis thiab ntshav ua li cas.
