原发性甲状旁腺功能亢进症甲状旁腺切除术后甲状旁腺激素水平升高。
Elevated parathyroid hormone levels after parathyroidectomy for primary hyperparathyroidism.
机构信息
Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
Head Neck. 2009 Nov;31(11):1456-60. doi: 10.1002/hed.21119.
BACKGROUND
Curative parathyroidectomy is associated with elevated levels of parathyroid hormone (PTH) with eucalcemia. This study sought to determine the frequency, clinical significance, and risk factors of this finding.
METHODS
Seventy-six consecutive patients surgically treated for primary hyperparathyroidism due to a single parathyroid adenoma in 2006 to 2007 were monitored for 1 month postoperatively; those with elevated PTH levels (>70 pg/mL) were monitored for 18 months.
RESULTS
Nineteen patients (25%) had high postoperative PTH levels with normal calcium levels. Compared with the remaining patients, this group had a significantly higher average preoperative PTH level (224.89 vs 156.86 pg/mL) and a lesser intraoperative decrease in PTH.
CONCLUSIONS
About 25% of eucalcemic patients may have elevated PTH levels after parathyroidectomy. A high preoperative PTH level (>225 pg/mL) may predict a persistently high postoperative level. Evaluation of blood and urine calcium, bone density, and cardiac function should be considered in affected patients.
背景
甲状旁腺切除术与甲状旁腺激素（PTH）水平升高和血钙正常有关。本研究旨在确定这种发现的频率、临床意义和危险因素。
方法
2006 年至 2007 年间，76 例因单个甲状旁腺腺瘤导致原发性甲状旁腺功能亢进症的患者接受了手术治疗，术后 1 个月进行监测；甲状旁腺激素水平升高（>70pg/mL）的患者进行了 18 个月的监测。
结果
19 例（25%）患者术后血钙正常但甲状旁腺激素水平升高。与其余患者相比，该组患者术前平均甲状旁腺激素水平明显较高（224.89 与 156.86pg/mL），术中甲状旁腺激素下降较少。
结论
约 25%的血钙正常患者在甲状旁腺切除术后可能会出现甲状旁腺激素水平升高。术前甲状旁腺激素水平较高（>225pg/mL）可能预示术后持续高水平。应考虑对受影响的患者进行血钙、尿钙、骨密度和心脏功能评估。
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