Redman Carolyn, Bodenner Donald, Stack Brendan
Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
Head Neck. 2009 Sep;31(9):1164-7. doi: 10.1002/hed.21082.
The aim of this study was to investigate vitamin D deficiency as an etiology for patients with elevated parathormone (PTH) levels after parathyroidectomy.
Fifity-five patients were identified who had undergone parathyroidectomy between January 2003 and November 2006 with complete records that included measurements of preoperative and postoperative PTH, vitamin D, calcium, ionized calcium, and sestamibi localization results.
Thirteen patients (24%) had elevated PTH at 1 week postoperatively. Sixty-two percent of these patients (N = 8, 15% overall) had vitamin D deficiency. Thirty-one percent (N = 4, 7% overall) had persistent biochemical evidence of primary hyperparathyroidism. Three of the 4 had a subsequent positive sestamibi parathyroid localization of an additional adenoma (5.5% series incidence of double adenomas).
Given the known prevalence of vitamin D deficiency, consideration should be given to preoperative vitamin D testing to avoid confusion about the etiology of persistently elevated PTH following surgery.
本研究旨在调查维生素D缺乏作为甲状旁腺切除术后甲状旁腺激素（PTH）水平升高患者的病因。
确定了55例在2003年1月至2006年11月期间接受甲状旁腺切除术的患者，其完整记录包括术前和术后PTH、维生素D、钙、离子钙的测量值以及 sestamibi定位结果。
13例患者（24%）术后1周时PTH升高。这些患者中有62%（N = 8，占总体的15%）存在维生素D缺乏。31%（N = 4，占总体的7%）有原发性甲状旁腺功能亢进的持续生化证据。4例中的3例随后sestamibi甲状旁腺定位发现额外的腺瘤呈阳性（双腺瘤的系列发病率为5.5%）。
鉴于已知维生素D缺乏的患病率，应考虑术前进行维生素D检测，以避免对术后PTH持续升高的病因产生混淆。
