Grill V, Murray R M, Ho P W, Santamaria J D, Pitt P, Potts C, Jerums G, Martin T J
St. Vincent's Institute of Medical Research, Fitzroy, Victoria, Australia.
J Clin Endocrinol Metab. 1992 Jun;74(6):1468-70. doi: 10.1210/jcem.74.6.1592895.
The effect of lowering ionized calcium on circulating parathyroid hormone (PTH) and parathyroid hormone-related protein (PTHrP) was assessed in twenty patients with hypercalcemia of malignancy following treatment with Pamidronate Disodium. Ionized calcium levels fell rapidly in all treated patients. PTH concentrations were initially suppressed below normal in 18 patients, but rose from 0.48 +/- 0.42 pmol/L to 3.63 +/- 3.13 pmol/L (p less than 0.01) after treatment, reaching higher than normal values in some patients even in the presence of persistent hypercalcemia. PTHrP concentrations did not change significantly after treatment. These findings are consistent with an increased sensitivity of parathyroid tissue to changes in ionized calcium following prolonged exposure to hypercalcemia. Regulation of tumor secretion of PTHrP by calcium was not apparent within the range of calcium concentrations in this study.
在20例接受帕米膦酸二钠治疗的恶性肿瘤高钙血症患者中，评估了降低离子钙对循环甲状旁腺激素（PTH）和甲状旁腺激素相关蛋白（PTHrP）的影响。所有接受治疗的患者离子钙水平迅速下降。18例患者的PTH浓度最初被抑制至正常水平以下，但治疗后从0.48±0.42 pmol/L升至3.63±3.13 pmol/L（p<0.01），即使在持续高钙血症的情况下，部分患者的PTH浓度仍高于正常水平。治疗后PTHrP浓度无明显变化。这些发现与甲状旁腺组织在长期暴露于高钙血症后对离子钙变化的敏感性增加一致。在本研究的钙浓度范围内，钙对肿瘤分泌PTHrP的调节作用不明显。
