Ziegler R
Abteilung Innere Medizin I (Endokrinologie und Stoffwechsel), Medizinische Universitätsklinik und Poliklinik, Heidelberg.
Chirurg. 1999 Oct;70(10):1077-81. doi: 10.1007/s001040050868.
Parathyroid excess may happen as a result of autonomous overactivity of the parathyroid glands (primary hyperparathyroidism). Secondary hyperparathyroidism is the consequence of chronic hypocalcemia, leading to parathyroid hyperplasia. Long-lasting secondary hyperparathyroidism may turn to autonomy in the sense of tertiary hyperparathyroidism. In primary hyperparathyroidism indications for surgical intervention are renal, intestinal or osseous organ manifestations, as well as relevant clinical symptoms of the so-called hypercalcemic syndrome. In truly asymptomatic primary hyperparathyroidism, observation is justified. However, the patients need regular supervision. If there is progression indicating health risk, the strategy must switch from observation to operation. Secondary hyperparathyroidism has must be treated by surgery if renal osteodystrophy progresses or tertiary hyperparathyroidism develops.
甲状旁腺功能亢进可能是由于甲状旁腺自主功能亢进（原发性甲状旁腺功能亢进）所致。继发性甲状旁腺功能亢进是慢性低钙血症的结果，导致甲状旁腺增生。长期的继发性甲状旁腺功能亢进可能会发展为自主性，即转变为三发性甲状旁腺功能亢进。在原发性甲状旁腺功能亢进中，手术干预的指征是肾脏、肠道或骨骼器官的表现，以及所谓高钙血症综合征的相关临床症状。在真正无症状的原发性甲状旁腺功能亢进中，进行观察是合理的。然而，患者需要定期监测。如果有进展表明存在健康风险，则治疗策略必须从观察转为手术。如果肾性骨营养不良进展或发展为三发性甲状旁腺功能亢进，继发性甲状旁腺功能亢进必须通过手术治疗。
