Department of Rheumatology and Nephrology, General Hospital of Air Force, Haidian District, Beijing, 100142, China.
Department of Rheumatology and Nephrology, General Hospital of Air Force, Haidian District, Beijing, 100142, China.
Asian J Surg. 2019 Jan;42(1):6-10. doi: 10.1016/j.asjsur.2018.04.001. Epub 2018 Jun 13.
Secondary hyperparathyroidism (SHPT) and calcium and phosphorus metabolism disorder are important complications in haemodialysis patients. Parathyroidectomy (PTX) may prevent or delay the progress of vascular calcification in haemodialysis patients.
To investigate the impacts of PTX on calcium and phosphorus metabolism, arterial calcification and arterial stiffness in haemodialysis patients with SHPT.
Twenty-one SHPT-haemodialysis patients were selected for PTX. The preoperative and postoperative 1-year scores of coronary artery calcification were measured via multislice spiral CT, along with the brachial-ankle pulse wave velocity (baPWV), and preoperative and postoperative 1-year indexes such as calcium, phosphorus, calcium-phosphorus product concentration and parathyroid hormone (PTH) level were compared.
Compared with the preoperative score, the postoperative 1-year coronary artery calcification score was significantly reduced; the mean baPWVs of the bilateral limbs were reduced; and the levels of serum calcium, phosphorus, calcium-phosphorus product concentration and PTH were all reduced; all differences were statistically significant (P < 0.05).
PTX can be used to correct calcium and phosphorus metabolism disorder, reduce arterial calcification, and improve arterial stiffness.
继发性甲状旁腺功能亢进症（SHPT）和钙磷代谢紊乱是血液透析患者的重要并发症。甲状旁腺切除术（PTX）可能预防或延缓血液透析患者血管钙化的进展。
探讨 PTX 对 SHPT 血液透析患者钙磷代谢、动脉钙化和动脉僵硬度的影响。
选择 21 例 SHPT 血液透析患者行 PTX，采用多层螺旋 CT 测量术前及术后 1 年冠状动脉钙化积分，同时测量肱踝脉搏波速度（baPWV），比较术前及术后 1 年的血钙、血磷、钙磷乘积浓度和甲状旁腺激素（PTH）水平等指标。
与术前评分相比，术后 1 年冠状动脉钙化评分显著降低；双侧肢体平均 baPWV 降低；血清钙、磷、钙磷乘积浓度和 PTH 水平均降低；差异均有统计学意义（P<0.05）。
PTX 可纠正钙磷代谢紊乱，减少动脉钙化，改善动脉僵硬度。
