Nilsson Inga-Lena, Lundgren Ewa, Ekbom Anders, Ljunghall Sverker, Rastad Jonas
Kirurgkliniken, Länssjukhuset, Sundsvall.
Lakartidningen. 2003 Nov 20;100(47):3848-50, 3853-4.
Primary hyperparathyroidism (HPT) is a common endocrine disease, in most cases without obvious symptoms of hypercalcemia and parathyroid hormone excess. The only curative treatment outside clinical trials is parathyroidectomy. Many patients are undiagnosed and left untreated, and the indications for curative treatment are still controversial. In 1990, NIH presented recommendations on the management of asymptomatic HPT, which was defined as HPT without symptoms and signs of renal or bone disease. Since then many studies have shed new light on mainly the cardiovascular complications and increased mortality of the disease, and the 1990 recommendations have been questioned. A workshop in 2002 revised the recommendations for handling of asymptomatic HPT in the United States. These recommendations are discussed from a Swedish perspective together with recent data on mortality in a large Swedish HPT cohort.
原发性甲状旁腺功能亢进症（HPT）是一种常见的内分泌疾病，在大多数情况下没有明显的高钙血症和甲状旁腺激素过量症状。临床试验之外唯一的治愈性治疗方法是甲状旁腺切除术。许多患者未被诊断出来且未接受治疗，而治愈性治疗的指征仍存在争议。1990年，美国国立卫生研究院（NIH）提出了关于无症状HPT管理的建议，无症状HPT被定义为没有肾脏或骨骼疾病症状和体征的HPT。从那时起，许多研究主要揭示了该疾病的心血管并发症和死亡率增加的情况，1990年的建议受到了质疑。2002年的一次研讨会修订了美国处理无症状HPT的建议。本文将从瑞典的角度讨论这些建议，并结合瑞典一个大型HPT队列的最新死亡率数据。
