Taniegra Edna D
Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205-7199, USA.
Am Fam Physician. 2004 Jan 15;69(2):333-9.
Primary hyperparathyroidism is the most frequent cause of hypercalcemia in ambulatory patients. The condition is most common in postmenopausal women, although it can occur in persons of all ages, including pregnant women. If symptoms are present, they are attributable to hypercalcemia and may include weakness, easy fatigability, anorexia, or anxiety. However, most persons have no symptoms, and primary hyperparathyroidism usually is diagnosed after an elevated serum calcium level is found incidentally on multiphasic chemistry panel testing. Persistent hypercalcemia and an elevated serum parathyroid hormone level are the diagnostic criteria for primary hyperparathyroidism. Other causes of hypercalcemia are rare, and usually are associated with low (or sometimes normal) parathyroid hormone levels. Malignancy is the most frequent cause of hypercalcemia in hospitalized patients. Parathyroidectomy is the definitive treatment for primary hyperparathyroidism. When performed by experienced endocrine surgeons, the procedure has success rates of 90 to 95 percent and a low rate of complications. Asymptomatic patients who decline surgery and meet criteria for medical management must commit to conscientious long-term monitoring. Any unexplained elevation of the serum calcium level should be evaluated promptly to prevent complications from hypercalcemia.
原发性甲状旁腺功能亢进是门诊患者高钙血症最常见的病因。这种疾病在绝经后女性中最为常见，不过所有年龄段的人都可能发病，包括孕妇。如果出现症状，通常是由高钙血症引起的，可能包括乏力、容易疲劳、厌食或焦虑。然而，大多数人没有症状，原发性甲状旁腺功能亢进通常是在多相化学检查中偶然发现血清钙水平升高后才得以诊断。持续性高钙血症和血清甲状旁腺激素水平升高是原发性甲状旁腺功能亢进的诊断标准。其他高钙血症的病因较为罕见，通常与甲状旁腺激素水平低（或有时正常）有关。恶性肿瘤是住院患者高钙血症最常见的病因。甲状旁腺切除术是原发性甲状旁腺功能亢进的确定性治疗方法。由经验丰富的内分泌外科医生进行该手术时，成功率为90%至95%，并发症发生率较低。拒绝手术且符合药物治疗标准的无症状患者必须坚持长期认真监测。血清钙水平任何无法解释的升高都应及时评估，以预防高钙血症的并发症。
