Glendenning P
Department of Core Clinical Pathology and Biochemistry, Royal Perth Hospital, Wellington Street, Perth, Western Australia 6000, Australia.
Intern Med J. 2003 Dec;33(12):598-603. doi: 10.1111/j.1445-5994.2003.00484.x.
Primary hyperparathyroidism (PHPT) is one of the most common endocrine disease processes, however the clinical presentation in 2003 is typically characterized by minimal signs or symptoms of hypercalcaemia or para-thyroid hormone (PTH) excess. Recent developments in imaging and management of PHPT have been published, however the area of biochemical investigation has been relatively neglected. A group of experts convened in April 2002 to consider whether changes were needed to the 1990 consensus guidelines which defined criteria for the diagnosis and management of asymptomatic PHPT. It is appropriate to review the revised recommendations, which have been disseminated by the panel and were recently published. Each of the laboratory -analytes used to establish the diagnosis of PHPT and exclude alternative diagnoses or complications will be considered in succession in this review: (i) calcium, (ii) intact PTH, (iii) urinary calcium and (iv) 25 hydroxy-vitamin D. Furthermore, critical appraisal of the new diagnostic criteria and their applicability to Australian laboratories will be addressed. Finally, limitations and problems associated with the measurement of each analyte will be reviewed.
原发性甲状旁腺功能亢进症（PHPT）是最常见的内分泌疾病之一，然而在2003年其临床表现通常以高钙血症或甲状旁腺激素（PTH）过量的轻微体征或症状为特征。关于PHPT影像学和治疗方面的最新进展已有报道，然而生化检查领域相对受到忽视。2002年4月，一组专家召开会议，探讨是否需要对1990年的共识指南进行修订，该指南界定了无症状PHPT的诊断和治疗标准。对该小组发布并于近期发表的修订建议进行回顾是恰当的。本综述将依次考量用于确诊PHPT并排除其他诊断或并发症的每种实验室分析物：（i）钙，（ii）完整PTH，（iii）尿钙，以及（iv）25羟维生素D。此外，还将对新的诊断标准及其在澳大利亚实验室的适用性进行批判性评估。最后，将对每种分析物测量中存在的局限性和问题进行回顾。
