Hamidi Sepehr, Soltani Akbar, Hedayat Anushiravan, Kamalian Nasser
Endocrinology and Metabolism Research Center (EMRC), Shariati Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Med Sci Monit. 2006 Feb;12(2):CR86-9. Epub 2006 Jan 26.
We designed a comprehensive study to explore different aspects of primary hyperparathyroidism in a series of Iranian patients. Our study aimed to elucidate the demographic, pathologic, biochemical, and surgical findings of these patients.
MATERIAL/METHODS: In a retrospective study from 1981 to 2003, we reviewed records of 177 patients operated on with the diagnosis of primary hyperparathyroidism in Shariati Hospital. Patients with secondary or tertiary hyperparathyroidism and those being re-operated were excluded.
88.1% of the lesions were adenoma, 9.6% hyperplasia, and 1 case proved to be carcinoma. In 1.7% of patients, no pathologic gland(s) were found. The majority of patients were female (female-to-male ratio: 5.5) and their mean age was 41.9+/-13.6 years. Most of the patients (77.6%) had mild hypercalcemia, and the mean calcium level was 11.2+/-0.8 mg/dl prior to surgery. Patients with hyperplasia had lower calcium levels than patients with adenoma 24 hours post-operation, with mean calcium levels of 8.1+/-1.2 mg/dl versus 9.03+/-1.2 mg/dl, respectively (p=0.02). Mean weight of adenomas was 4.1 gram (range 0.8-25 g). Adenomas were mostly (74%) located in lower parathyroid glands and 6.3% of them were ectopic.
Primary hyperparathyroidism should be expected at younger ages in Iran. Parathyroid hyperplasia in a patient should alert the surgeon of the higher risk of postoperative hypocalcemia.
我们设计了一项综合性研究，以探究一系列伊朗原发性甲状旁腺功能亢进患者的不同方面。我们的研究旨在阐明这些患者的人口统计学、病理学、生化及手术方面的发现。
材料/方法：在一项1981年至2003年的回顾性研究中，我们查阅了在沙里亚蒂医院接受手术治疗且诊断为原发性甲状旁腺功能亢进的177例患者的记录。排除继发性或三发性甲状旁腺功能亢进患者以及再次接受手术的患者。
88.1%的病变为腺瘤，9.6%为增生，1例为癌。1.7%的患者未发现病理性腺体。大多数患者为女性（男女比例为5.5），平均年龄为41.9±13.6岁。大多数患者（77.6%）有轻度高钙血症，术前平均血钙水平为11.2±0.8mg/dl。增生患者术后24小时血钙水平低于腺瘤患者，平均血钙水平分别为8.1±1.2mg/dl和9.03±1.2mg/dl（p=0.02）。腺瘤平均重量为4.1克（范围为0.8 - 25克）。腺瘤大多（74%）位于下甲状旁腺，其中6.3%为异位。
在伊朗，原发性甲状旁腺功能亢进在较年轻患者中也应予以考虑。患者出现甲状旁腺增生应提醒外科医生术后发生低钙血症的风险较高。
