Dokupilova A, Payer J
Bratisl Lek Listy. 2016;117(9):495-500. doi: 10.4149/bll_2016_096.
Patients with primary hyperparathyroidism are characterized by increased calcium plasma concentrations, which in turn could have a potential to induce ECG changes, especially shortening of the QT interval. Therefore, the aim of this study was to evaluate, whether the routine 24-hours outpatient ECG monitoring could be used for screening the primary hyperparathyroidism.
Totally, 31 patients (mean age, 59.2 ± 12.99 years) with primary hyperparathyroidism were compared to 20 healthy controls. All patients underwent mineral metabolism biochemical evaluation, ultrasound or scintigraphy of the neck, and a 24-hour outpatient ECG. The device detected QT, QTc, and RR intervals during a 24-hour period.
Significantly higher calcium concentrations were confirmed in patients when compared to controls (2.38 ± 0.12 vs 2.92 ± 0.29 mmol/l; p < 0.001). However, no significant differences were found between controls and patients in QT interval and overall heart rate.
Although shortening of the QT interval is a common ECG finding in patients with hyperparathyroidism, it seems that 24-hour outpatient ECG is not suitable for primary hyperparathyroidism screening (Tab. 2, Fig. 4, Ref. 28).
原发性甲状旁腺功能亢进患者的特征是血浆钙浓度升高，这反过来可能会诱发心电图改变，尤其是QT间期缩短。因此，本研究的目的是评估常规24小时门诊心电图监测是否可用于筛查原发性甲状旁腺功能亢进。
总共将31例原发性甲状旁腺功能亢进患者（平均年龄59.2±12.99岁）与20例健康对照者进行比较。所有患者均接受了矿物质代谢生化评估、颈部超声或闪烁扫描以及24小时门诊心电图检查。该设备在24小时内检测QT、QTc和RR间期。
与对照组相比，患者的钙浓度明显更高（2.38±0.12 vs 2.92±0.29 mmol/l；p<0.001）。然而，对照组和患者在QT间期和总体心率方面未发现显著差异。
虽然QT间期缩短是甲状旁腺功能亢进患者常见的心电图表现，但24小时门诊心电图似乎不适用于原发性甲状旁腺功能亢进的筛查（表2，图4，参考文献28）。
