Liu Jun, Huang Qinghua, Yang Meng, Huang Linping, Zhang Ling
Department of General Surgery, China-Japan Friendship Hospital, Beijing, China.
Digital Plastic Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing, China.
J Int Med Res. 2020 Jan;48(1):300060519897505. doi: 10.1177/0300060519897505.
This study was performed to investigate the risk factors for severe hypocalcemia (SH) after total parathyroidectomy without autotransplantation (TPTX) in patients with secondary hyperparathyroidism.
We retrospectively analyzed the records of 136 patients with secondary hyperparathyroidism treated by TPTX. The patients were categorized as having SH or non-SH based on their postoperative blood calcium concentration. The risk factors for SH were identified by comparing the clinical characteristics between the two groups and by performing multiple logistic regression analyses.
After surgery, 46.0% of the patients had hypocalcemia and 31.7% had SH. Evidence of renal osteodystrophy on lumbar radiographs and the serum concentrations of intact parathyroid hormone (iPTH), calcium, and alkaline phosphatase (ALP) were different between the two groups. The SH group had higher preoperative iPTH and ALP concentrations than the non-SH group. In addition, more patients with SH showed renal osteodystrophy. Logistic regression analyses indicated that preoperative hypocalcemia and a high ALP concentration were independent predictors of SH.
Preoperative hypocalcemia and a high ALP concentration were identified as risk factors for SH following TPTX.
本研究旨在调查继发性甲状旁腺功能亢进患者在未进行自体移植的甲状旁腺全切术后发生严重低钙血症（SH）的危险因素。
我们回顾性分析了136例接受甲状旁腺全切术治疗的继发性甲状旁腺功能亢进患者的记录。根据患者术后血钙浓度将其分为SH组或非SH组。通过比较两组的临床特征并进行多因素逻辑回归分析来确定SH的危险因素。
术后，46.0%的患者发生低钙血症，31.7%的患者发生SH。两组患者腰椎X线片上的肾性骨营养不良证据以及血清完整甲状旁腺激素（iPTH）、钙和碱性磷酸酶（ALP）浓度存在差异。SH组术前iPTH和ALP浓度高于非SH组。此外，更多SH患者表现出肾性骨营养不良。逻辑回归分析表明，术前低钙血症和高ALP浓度是SH的独立预测因素。
术前低钙血症和高ALP浓度被确定为甲状旁腺全切术后SH的危险因素。
