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[内分泌学新闻:2014年无症状原发性甲状旁腺功能亢进症的管理]

[News in endocrinology: Management of asymptomatic primary hyperparathyroidism in 2014].

作者信息

Köhler Ballan B, Philippe J

出版信息

Rev Med Suisse. 2015 Jan 14;11(456-457):58-61.

Abstract

Primary hyperparathyroidism, a disorder in wich there is a hypercalcemia caused by autonomous hypersecretion of parathormone, usually by parathyroid adenoma. It is asymptomatic in most cases. After excluding a cause of secondary elevation of parathyroid hormone, a search for renal stones and osteoporosis has to be done. The treatment of choice is parathyroidectomy and it is recommended in case of complications, hypercalcemia with calcium up to 0.25 mmol/l higher than the upper limit and in patients <50 years. Specific pharmacological approaches (bisphosphonate or cinacalcet) may be of value if the patient meet surgical guidelines but is not a candidate for parathyroid surgery. Patient who do not meet surgical indications should be monitored.

摘要

原发性甲状旁腺功能亢进症是一种由于甲状旁腺激素自主分泌过多(通常由甲状旁腺腺瘤引起)导致高钙血症的疾病。大多数情况下它是无症状的。在排除继发性甲状旁腺激素升高的原因后,必须排查肾结石和骨质疏松症。首选治疗方法是甲状旁腺切除术,对于出现并发症、血钙高于上限0.25 mmol/L的高钙血症以及年龄小于50岁的患者建议进行手术。如果患者符合手术指征但不适合进行甲状旁腺手术,特定的药物治疗方法(双膦酸盐或西那卡塞)可能有价值。不符合手术指征的患者应接受监测。

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