Heath D A
University of Birmingham, Queen Elizabeth Hospital, Edgbaston, UK.
Curr Opin Rheumatol. 1991 Jun;3(3):490-5. doi: 10.1097/00002281-199106000-00024.
Primary hyperparathyroidism is a common condition infrequently complicated by renal stones and overt bone disease. Most cases are asymptomatic or have vague, nonspecific symptoms. There is considerable debate as to whether mild or asymptomatic cases should be managed surgically or conservatively. Important chromosomal abnormalities have now been demonstrated in some parathyroid adenomas. Renal osteodystrophy remains a difficult condition to treat once it is fully established. The use of vitamin D metabolites in the early stages of renal failure and the maintenance of a normal serum calcium and phosphate appear to prevent the development of secondary hyperparathyroidism. Further studies are required to ascertain the optimum way of using vitamin D metabolites and how best to reduce serum phosphorus.
原发性甲状旁腺功能亢进是一种常见疾病，很少并发肾结石和明显的骨病。大多数病例无症状或有模糊、非特异性症状。对于轻度或无症状病例应采用手术治疗还是保守治疗存在相当大的争议。现已在一些甲状旁腺腺瘤中发现重要的染色体异常。肾性骨营养不良一旦完全形成，治疗仍然困难。在肾衰竭早期使用维生素D代谢物并维持正常的血清钙和磷水平似乎可预防继发性甲状旁腺功能亢进的发生。需要进一步研究以确定使用维生素D代谢物的最佳方法以及如何最好地降低血清磷水平。
