Kaplan R A, Snyder W H, Stewart A, Pak C Y
J Clin Endocrinol Metab. 1976 Mar;42(3):415-26. doi: 10.1210/jcem-42-3-415.
Effects of parathyroidectomy on parathyroid function and calcium (Ca) metabolism were carefully evaluated in 6 patients with primary hyperparathyroidism without symptoms normally attributed to the disease and in 7 with bone disease or nephrolithiasis. Before parathyroidectomy, both groups of patients demonstrated evidence of the sequelae of parathyroid hormone (PTH) excess, since they presented one or more of the following features: low bone density by 125I-photon absorption, hypercalciuria (urinary Ca greater than 200 mg/day on an intake of 400 mg/day), negative Ca balance (absorbed Ca less than urinary Ca), elevated fasting urinary Ca greater than 0.2 mg/mg creatinine for a night-time sample after a 6-hour fast), and decreased renal function (creatinine clearance of less than 65 ml/min). Following parathyroidectomy, most of these deleterious effects were reversed commensurate with the return of immunoreactive serum PTH, serum Ca, and urinary cyclic AMP toward normal. These quantitative non-invasive techniques may be useful for the initial evaluation and follow-up of patients with asymptomatic primary hyperparathyroidism.
在6例无通常归因于原发性甲状旁腺功能亢进的症状的患者以及7例患有骨病或肾结石的患者中，仔细评估了甲状旁腺切除对甲状旁腺功能和钙（Ca）代谢的影响。在甲状旁腺切除术前，两组患者均表现出甲状旁腺激素（PTH）过量的后遗症证据，因为他们呈现出以下一种或多种特征：通过125I光子吸收法测定的骨密度低、高钙尿症（摄入400mg/天钙时尿Ca大于200mg/天）、负钙平衡（吸收的Ca小于尿Ca）、禁食过夜6小时后夜间样本中空腹尿Ca大于0.2mg/mg肌酐以及肾功能下降（肌酐清除率小于65ml/min）。甲状旁腺切除术后，随着免疫反应性血清PTH、血清Ca和尿环磷酸腺苷恢复正常，这些有害影响大多得到逆转。这些定量非侵入性技术可能有助于对无症状原发性甲状旁腺功能亢进患者进行初始评估和随访。
