Peng Chengzhong, Zhang Zhengxian, Liu Jibin, Chen Hongyu, Tu Xiao, Hu Rihong, Ni Jun, Weng Ning, Pang Haisu, Xue Zhengmei
Department of Ultrasound, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang Province, China.
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Head Neck. 2017 Mar;39(3):564-571. doi: 10.1002/hed.24657. Epub 2016 Dec 29.
The purpose of this study was to determine if ultrasound-guided radiofrequency ablation (RFA) of hyperplastic parathyroid glands could be used to treat secondary hyperparathyroidism (HPT) in patients with chronic kidney disease.
RFA of the hyperplastic parathyroid glands was performed in 34 patients with secondary HPT. Intact parathyroid hormone (iPTH), calcium, and phosphorus were measured. The outcome was based on the ablation extent (ie, 4, 3, and 1-2 glands).
The iPTH, calcium, and phosphorus levels decreased in all groups after RFA. One year after ablation, these parameters remained significantly lower in the 4-gland ablation group compared with the 3-gland and 1 to 2-gland groups. The same tendency was observed for the symptom score. The iPTH levels of <272 pg/mL on the day after ablation was the best predictor for maintaining parathyroid hormone (PTH) levels in a reasonable range 1 year after ablation.
RFA of hyperplastic parathyroid glands for treating secondary HPT is feasible in selected patients. © 2016 Wiley Periodicals, Inc. Head Neck 39: 564-571, 2017.
本研究旨在确定超声引导下增生性甲状旁腺射频消融术（RFA）是否可用于治疗慢性肾脏病患者的继发性甲状旁腺功能亢进症（HPT）。
对34例继发性HPT患者进行增生性甲状旁腺的RFA治疗。检测血清全段甲状旁腺激素（iPTH）、钙和磷水平。治疗效果根据消融范围（即4个、3个以及1 - 2个甲状旁腺）来评估。
RFA治疗后所有组的iPTH、钙和磷水平均下降。消融术后1年，4个甲状旁腺消融组的这些参数仍显著低于3个甲状旁腺消融组和1 - 2个甲状旁腺消融组。症状评分也呈现相同趋势。消融术后第1天iPTH水平<272 pg/mL是1年后将甲状旁腺激素（PTH）水平维持在合理范围的最佳预测指标。
对于选定的患者，采用增生性甲状旁腺RFA治疗继发性HPT是可行的。© 2016威利期刊公司。《头颈外科》39: 564 - 571, 2017。
