Tsang R C, Chen I W, McEnery P, Brown D R, Johnson J R, Lesniewicz J
J Pediatr. 1976 Feb;88(2):250-6. doi: 10.1016/s0022-3476(76)80990-0.
To determine the functional capabilities of the parathyroid glands, 17 EDTA infusions were given to 11 children (ages 1 month to 12 years) and to two mothers of four of the children. Serum ionized Ca fell from 4.1 mg/dl to 3.4 mg/dl. Excessive parathyroid hormone responses were elicited during seven of nine EDTA infusions in five children and in one adult with hypophosphatemic rickets, during the active phase of rickets. In four of five subjects with problems related to hypercalcemia, borderline low or undetectable PTH responses were elicited. Three relatively normal PTH responses were obtained, two in an infant after phosphate-induced hypocalcemic tetany was corrected, and one in a child with a malabsorption syndrome. The renal tubular reabsorption of phosphate was inversely related and the urinary cyclic AMP excretion was positively related to the PTH response. Thus EDTA infusions in infants and children might be useful in the identification of hyper-, normo-, or hypoparathyroid states and would be of value in defining the functional condition of the parathyroid glands in children with deranged Ca or P metabolism.
为了确定甲状旁腺的功能,对11名儿童(年龄从1个月至12岁)以及其中4名儿童的两位母亲进行了17次乙二胺四乙酸(EDTA)输注。血清离子钙从4.1毫克/分升降至3.4毫克/分升。在五名儿童和一名患有低磷血症性佝偻病的成年人处于佝偻病活动期时,九次EDTA输注中有七次引发了过度的甲状旁腺激素反应。在五名与高钙血症相关问题的受试者中,有四名引发了临界低或无法检测到的甲状旁腺激素反应。获得了三次相对正常的甲状旁腺激素反应,两次是在一名婴儿的磷酸盐诱导性低钙血症性手足搐搦得到纠正之后,一次是在一名患有吸收不良综合征的儿童中。肾小管对磷酸盐的重吸收呈负相关,而尿中环磷酸腺苷(cAMP)排泄与甲状旁腺激素反应呈正相关。因此,对婴幼儿进行EDTA输注可能有助于识别甲状旁腺功能亢进、正常或减退状态,并且对于确定钙或磷代谢紊乱儿童的甲状旁腺功能状况具有价值。