Schaefer F, Mehls O, Ritz E
Department of Pediatrics, University of Heidelberg, FRG.
Miner Electrolyte Metab. 1992;18(2-5):169-73.
Secondary hyperparathyroidism occurs in the very early stages of renal failure. In the past, there has been considerable controversy concerning the signal triggering secondary hyperparathyroidism. Recently, it has become clear that secondary hyperparathyroidism is, at least to a major extent, the consequence of the deranged endocrine feedback between calcitriol, the secretory product of renal 1-alpha-hydroxylase, and parathyroid hormone. Another recent insight concerns disturbances of the secretion of hypophyseal hormones. These hormones, e.g. GH, gonadotropins and TSH, are secreted in a pulsatile fashion. For all three hormones, reversible abnormalities of secretory rhythmicity have been demonstrated in renal failure. Disturbed oscillatory patterns of hormone secretion provide a new dimension to our understanding of the genesis of endocrine disturbances.
继发性甲状旁腺功能亢进发生在肾衰竭的极早期。过去，关于引发继发性甲状旁腺功能亢进的信号存在相当大的争议。最近，已经明确继发性甲状旁腺功能亢进至少在很大程度上是肾1-α-羟化酶的分泌产物骨化三醇与甲状旁腺激素之间内分泌反馈紊乱的结果。最近的另一项见解涉及垂体激素分泌的紊乱。这些激素，如生长激素、促性腺激素和促甲状腺激素，以脉冲方式分泌。对于所有这三种激素，在肾衰竭中已证实存在分泌节律的可逆异常。激素分泌的振荡模式紊乱为我们理解内分泌紊乱的发生提供了一个新的视角。
