Naafs M A, Fischer H R, van der Velden P C, Mulder H, Hackeng W H, Schopman W, Koorevaar G, Silberbusch J
Acta Endocrinol (Copenh). 1986 Dec;113(4):543-50. doi: 10.1530/acta.0.1130543.
Ten hypercalcaemic patients with solid tumours were studied to evaluate the renal response on PTH infusion as assessed by nephrogenous cAMP excretion and maximum tubular re-absorption of phosphate. In addition, 20 normocalcaemic patients, 11 with an adenocarcinoma and 9 with a squamous cell carcinoma, were studied. All cancer patients had moderately extensive disease. Results were compared with those of 9 patients with primary hyperparathyroidism and with 10 elderly controls. All groups studied had comparable renal function, magnesium and 25-hydroxy-vitamin D levels. Comparable results were obtained in patients with an adenocarcinoma and in controls. cAMP response (delta nephrogenous cAMP) was significantly lower in the hypercalcaemic patients with a solid tumour compared with the controls (8.13 +/- 4.68 nmol/100 ml glomerular filtrate vs 29.52 +/- 25.62 nmol/100 ml glomerular filtrate; P less than 0.005). In the group of patients with primary hyperparathyroidism delta nephrogenous cAMP was 13.41 +/- 7.54 nmol/100 ml glomerular filtrate (P less than 0.06 vs controls). The group of patients with a squamous cell cancer showed an intermediate value of 14.83 +/- 10.74 nmol/100 ml glomerular filtrate (P less than 0.025 vs the normocalcaemic adenocarcinoma patients, but NS vs controls). In two hypercalcaemic patients with a solid tumour in whom PTH infusion was repeated after normalization of serum calcium no influence on renal responsiveness was observed. Responses of maximum tubular re-absorption of phosphate were lowest in the group of hypercalcaemic patients with a solid tumour and in the patients with primary hyperparathyroidism compared with controls (0.11 +/- 0.10 vs 0.22 +/- 0.09 mmol/l and 0.09 +/- vs 0.22 +/- 0.09 mmol/l; P less than 0.025 and P less than 0.005, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
对10例患有实体瘤的高钙血症患者进行了研究，以评估静脉注射甲状旁腺激素（PTH）时的肾脏反应，评估指标为肾源性环磷酸腺苷（cAMP）排泄和肾小管对磷酸盐的最大重吸收。此外，还研究了20例血钙正常的患者，其中11例患有腺癌，9例患有鳞状细胞癌。所有癌症患者均患有中度广泛的疾病。将结果与9例原发性甲状旁腺功能亢进患者和10例老年对照者的结果进行了比较。所有研究组的肾功能、镁和25-羟维生素D水平相当。腺癌患者和对照组获得了相似的结果。与对照组相比，患有实体瘤的高钙血症患者的cAMP反应（肾源性cAMP变化量）显著降低（8.13±4.68 nmol/100 ml肾小球滤过液 vs 29.52±25.62 nmol/100 ml肾小球滤过液；P<0.005）。原发性甲状旁腺功能亢进患者组的肾源性cAMP变化量为13.41±7.54 nmol/100 ml肾小球滤过液（与对照组相比，P<0.06）。鳞状细胞癌患者组的中间值为14.83±10.74 nmol/100 ml肾小球滤过液（与血钙正常的腺癌患者相比，P<0.025，但与对照组相比无统计学意义）。在2例患有实体瘤的高钙血症患者中，血钙正常后重复静脉注射PTH，未观察到对肾脏反应性的影响。与对照组相比，患有实体瘤的高钙血症患者组和原发性甲状旁腺功能亢进患者组的肾小管对磷酸盐的最大重吸收反应最低（0.11±0.10 vs 0.22±0.09 mmol/l和0.09± vs 0.22±0.09 mmol/l；分别为P<0.025和P<0.005）。（摘要截断于250字）
