Rudnicki M, McNair P, Transbøl I, Lindgren P
Department of Clinical Chemistry, Hvidovre Hospital, University of Copenhagen, Denmark.
J Intern Med. 1990 Nov;228(5):465-70. doi: 10.1111/j.1365-2796.1990.tb00264.x.
We compared measurements of parathyroid hormone (PTH) using two assays, in order to detect intact PTH and midregion/C-terminal PTH (M/C-PTH) in a variety of calcium metabolic disorders. The series consisted of a total of 101 patients, including subjects with primary hyperparathyroidism (n = 24), hypoparathyroidism (n = 18), hypercalcaemia of malignancy (n = 10), moderate chronic renal failure (n = 14), chronic renal failure undergoing haemodialysis (n = 19), and small bowel disorders (n = 16). The intact PTH assay was superior to the M/C-PTH assay in reflecting parathyroid function in primary hyperparathyroidism, hypoparathyroidism and hypercalcaemia of malignancy. In patients with chronic renal failure, both assays were indicators of a comparable number of patients with elevated PTH levels. Intact PTH proved most reliable in detecting changes in parathyroid hormone secretion in response to variations in ionized calcium induced by haemodialysis. In patients with extensive intestinal resection, both assays showed increased levels of PTH. It is concluded that measurement of intact PTH is a more reliable index of parathyroid function than measurement of midregion/C-terminal PTH. Thus such an approach should be the one of choice for clinical evaluation of calcium homeostasis.
我们使用两种检测方法对甲状旁腺激素（PTH）进行测量比较，以检测各种钙代谢紊乱患者体内的完整PTH以及中段/羧基末端PTH（M/C-PTH）。该系列研究共纳入101例患者，包括原发性甲状旁腺功能亢进患者（n = 24）、甲状旁腺功能减退患者（n = 18）、恶性肿瘤高钙血症患者（n = 10）、中度慢性肾衰竭患者（n = 14）、接受血液透析的慢性肾衰竭患者（n = 19）以及小肠疾病患者（n = 16）。在反映原发性甲状旁腺功能亢进、甲状旁腺功能减退和恶性肿瘤高钙血症患者的甲状旁腺功能方面，完整PTH检测优于M/C-PTH检测。在慢性肾衰竭患者中，两种检测方法均显示出相当数量的PTH水平升高患者。完整PTH在检测血液透析引起的离子钙变化导致的甲状旁腺激素分泌变化方面最为可靠。在广泛肠道切除的患者中，两种检测方法均显示PTH水平升高。结论是，与测量中段/羧基末端PTH相比，测量完整PTH是甲状旁腺功能更可靠的指标。因此，这种方法应成为临床评估钙稳态的首选方法。
