Jansson S, Grimby G, Hagne I, Hedman I, Tisell L E
Department of Surgery, Sahlgren's Hospital, University of Gothenburg, Sweden.
Eur J Surg. 1991 Jan;157(1):13-6.
In 23 unselected cases of primary hyperparathyroidism (pHPT), muscle strength, morphology and enzymatic activities were studied and electromyography (EMG) performed before and 6 months after surgical treatment. Hypercalcemia was mostly mild or moderate. Nine women undergoing surgery for benign thyroid conditions served as controls regarding muscle strength, while muscle morphologic and enzymatic data were compared with findings in healthy persons of similar age. Only three pHPT patients reported muscle weakness preoperatively, and two were subjectively improved after surgery. Muscle strength did not differ significantly before or after operation between patients and controls: After surgery both groups showed increased isokinetic muscle strength at higher angular velocities. Nor did muscle morphology differ between pHPT patients and controls. No conclusive EMG changes were found before or after surgery for pHPT but postoperatively the pHPT patients showed significant increase in glycolytic but not oxidative muscle enzymes, possibly reflecting early effect of pHPT on especially type II fibers, which previously were shown to be most extensively involved in pHPT. Otherwise no measurable negative effects of mild or moderate pHPT were found on muscle strength or function.
在23例未经挑选的原发性甲状旁腺功能亢进症（pHPT）患者中，研究了手术治疗前及术后6个月的肌肉力量、形态及酶活性，并进行了肌电图（EMG）检查。高钙血症大多为轻度或中度。9例因良性甲状腺疾病接受手术的女性作为肌肉力量方面的对照，同时将肌肉形态学和酶学数据与年龄相仿的健康人进行比较。术前只有3例pHPT患者报告有肌无力，术后2例主观感觉有所改善。患者与对照组术前和术后的肌肉力量无显著差异：术后两组在较高角速度下等速肌肉力量均增加。pHPT患者与对照组的肌肉形态也无差异。pHPT患者手术前后未发现明确的肌电图变化，但术后pHPT患者糖酵解性肌肉酶显著增加，而氧化型肌肉酶无变化，这可能反映了pHPT对Ⅱ型纤维的早期影响，此前研究表明Ⅱ型纤维在pHPT中受累最为广泛。除此之外，未发现轻度或中度pHPT对肌肉力量或功能有可测量的负面影响。
