Division of Endocrinology SUNY Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203, USA.
Maturitas. 2011 Nov;70(3):246-55. doi: 10.1016/j.maturitas.2011.07.021. Epub 2011 Sep 23.
Primary hyperparathyroidism (PHPT) is the third most common endocrinopathy seen today, and is most frequently found in the 6th to 7th decade of life. PHPT can present with various degrees of symptoms, and can affect many organ systems, including the skeletal, renal, central nervous system and cardiovascular system. Despite this, the most common presentation of hyperparathyroidism is "asymptomatic" with the diagnosis being made incidentally with the initial finding of hypercalcemia on routine laboratory studies, leading to further investigation. Surgical versus medical management is usually based on factors such as age and complications related to hyperparathyroidism (i.e. the presence of renal stones, renal insufficiency and bone loss and significant increases in serum calcium). Treatment options include parathyroidectomy, bisphosphonates, calcitonin and calcimimetics. In this review, we discuss primary hyperparathyroidism in detail with a focus on clinical manifestations particularly in the elderly population. We highlight the indications for surgical versus medical management and compare some of the uses of newer therapeutic agents relative to traditional ones.
原发性甲状旁腺功能亢进症（PHPT）是当今第三大常见的内分泌疾病，最常发生在生命的第 6 至 7 个十年。PHPT 可以表现出不同程度的症状，并可能影响许多器官系统，包括骨骼、肾脏、中枢神经系统和心血管系统。尽管如此，甲状旁腺功能亢进症最常见的表现是“无症状”，其诊断是通过常规实验室研究最初发现高钙血症偶然发现的，从而进行进一步的检查。手术与药物治疗的选择通常基于年龄和与甲状旁腺功能亢进症相关的并发症等因素（即肾结石、肾功能不全和骨丢失以及血清钙显著升高）。治疗选择包括甲状旁腺切除术、双膦酸盐、降钙素和钙敏感受体激动剂。在这篇综述中，我们详细讨论了原发性甲状旁腺功能亢进症，特别关注老年人的临床表现。我们强调了手术与药物治疗的适应证，并比较了一些新的治疗药物与传统药物的用途。
