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新诊断的原发性甲状旁腺功能亢进症高血压患者的颈-股脉搏波速度显著增加,且与血清钙水平显著相关。

Carotid-femoral pulse wave velocity is significantly increased in newly diagnosed hypertensive patients with primary hyperparathyroidism and significantly related with serum calcium level.

机构信息

Department of Medical Oncology, University of Health Sciences - Adana Health Practice and Research Center, Dr. Mithat Özsan Bulvarı Kışla Mah. 4522 Sok. No: 1 Yüreğir, 01230, Adana, Turkey.

Department of Gastroenterology, University of Health Sciences - Adana Health Practice and Research Center, Adana, Turkey.

出版信息

J Ultrasound. 2021 Dec;24(4):439-446. doi: 10.1007/s40477-020-00512-4. Epub 2020 Jul 23.

Abstract

BACKGROUND

Primary hyperparathyroidism (PHP) is a rare cause of secondary hypertension (HT), but in patients with PHP, HT is very common and 20-80% of patients have HT. The aim of this study was to evaluate the change in carotid-femoral pulse wave velocity (CF-PWV) in hypertensive patients with PHP, and was to determine the clinical, laboratory, and echocardiographic parameters associated with CF-PWV.

METHODS

The study included 83 newly diagnosed hypertensive patients with PHP and 83 patients with newly diagnosed essential HT without PHP. All patients underwent echocardiography and CF-PWV measurements.

RESULTS

In patients with PHP, blood urea nitrogen, hs-CRP, uric acid, serum and urine calcium, parathyroid hormone level, CF-PWV value, LV wall thickness, LVMI, aortic and left atrium (LA) diameter, and presence of LVH and CF-PWV > 10 m/s were higher, and serum phosphorus levels were lower. Serum calcium, LA diameter, and LVMI values were closely correlated with CF-PWV. In the ROC analysis, the AUROC was calculated as 0.825 for calcium level to determine the patients with increased CF-PWV. When the serum calcium value was taken as 10 mg/dL, it was determined with CF-PWV > 10 m/s were 79.5% sensitivity and 78.2% specificity.

CONCLUSION

CF-PWV significantly increases in newly diagnosed hypertensive patients with PHP and significantly related to serum calcium level. To protect against target organ damage, high serum calcium levels should be monitored as well as blood pressure in hypertensive patients with PHP.

摘要

背景

甲状旁腺功能亢进症(PHP)是继发性高血压(HT)的罕见原因,但在 PHP 患者中,HT 非常常见,20-80%的患者有 HT。本研究旨在评估 PHP 伴高血压患者的颈股脉搏波速度(CF-PWV)的变化,并确定与 CF-PWV 相关的临床、实验室和超声心动图参数。

方法

本研究纳入了 83 例新诊断的 PHP 伴高血压患者和 83 例新诊断的无 PHP 的原发性高血压患者。所有患者均接受了超声心动图和 CF-PWV 测量。

结果

在 PHP 患者中,血尿素氮、hs-CRP、尿酸、血清和尿钙、甲状旁腺激素水平、CF-PWV 值、左心室壁厚度、LVMI、主动脉和左心房(LA)直径、LVH 和 CF-PWV>10 m/s 的存在更高,血清磷水平更低。血清钙、LA 直径和 LVMI 值与 CF-PWV 密切相关。在 ROC 分析中,计算出血清钙水平的 AUROC 为 0.825,以确定 CF-PWV 升高的患者。当血清钙值为 10 mg/dL 时,CF-PWV>10 m/s 的灵敏度为 79.5%,特异性为 78.2%。

结论

新诊断的 PHP 伴高血压患者的 CF-PWV 显著升高,与血清钙水平显著相关。为了防止靶器官损伤,应监测 PHP 伴高血压患者的高血清钙水平以及血压。

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