Endo Itsuro, Matsumoto Toshio
Department of Medicine and Bioregulatory Sciences, The University of Tokushima Graduate School of Health Biosciences.
Nihon Rinsho. 2006 Sep;64(9):1718-23.
Primary hyperparathyroidism is the most frequent cause of hypercalcemia in ambulatory patients. Elevated serum parathyroid hormone in the presence of persistent hypercalcemia is the diagnostic sine qua non for primary hyperthyroidism. Since examination of serum calcium became a routine diagnostic test, most patients with primary hyperparathyroidism are asymptomatic at the time of diagnosis. Primary hyperparathyroidism in most of patients is caused by parathyroid adenoma, and parathyroid hyperplasia and cancer are rare causes of the disorder. Parathyroidectomy is the primary treatment of choice for primary hyperparathyroidism by any cause. Parathyroidectomy should be performed in most of patients with primary hyperparathyroidism, but asymptomatic or only mildly hypercalcemic patients are treated according to the guidelines for surgical treatment established by the NIH Consensus Development Conference in 2002. For patients with osteoporosis who are not indicated for or decline surgical procedures can be treated with bisphosphonates.
原发性甲状旁腺功能亢进是门诊患者高钙血症最常见的原因。在持续性高钙血症情况下血清甲状旁腺激素升高是原发性甲状旁腺功能亢进的诊断必要条件。自从血清钙检测成为常规诊断试验以来，大多数原发性甲状旁腺功能亢进患者在诊断时无症状。大多数患者的原发性甲状旁腺功能亢进由甲状旁腺腺瘤引起，甲状旁腺增生和癌症是该疾病的罕见病因。甲状旁腺切除术是任何原因引起的原发性甲状旁腺功能亢进的主要治疗选择。大多数原发性甲状旁腺功能亢进患者都应进行甲状旁腺切除术，但无症状或仅有轻度高钙血症的患者应根据美国国立卫生研究院共识发展会议2002年制定的手术治疗指南进行治疗。对于不适合或拒绝手术的骨质疏松症患者，可使用双膦酸盐进行治疗。
