Kruse K, Kracht U, Wohlfart K, Kruse U
Universitäts-Kinderklinik Würzburg.
Dtsch Med Wochenschr. 1988 Feb 26;113(8):283-8. doi: 10.1055/s-2008-1067631.
Intact parathormone (PTH 1-84) was measured with a new immunoradiometric method in serum from 83 children and adults with various abnormalities of calcium metabolism. The results were compared with those of an assay of midregional PTH fraction (44-68). Both measurements discriminated well between normal controls and patients with primary or secondary hyperparathyroidism. In patients in chronic renal failure intact PTH measurement was best for demonstrating parathyroid secretion. An important advantage of the new method is in the diagnosis of PTH hyposecretion in hypoparathyroidism and of tumour hypercalcaemia, which is not possible by mid-regional PTH determination. Intravenous injection of calcium (2 mg/kg over 5 min) and of synthetic PTH fragment (6 U/kg 1-38 hPTH over 2 min) caused a reduction in intact serum-PTH to about half the initial value after five minutes. Measuring intact PTH is thus a suitable method for determining both raised and decreased parathyroid secretion in disease and in the course of function tests. It is simple to perform, subject to only minor interference, and thus suitable also as a routine laboratory test.
采用一种新的免疫放射分析法,对83例患有各种钙代谢异常的儿童和成人血清中的完整甲状旁腺激素(PTH 1 - 84)进行了检测。将结果与甲状旁腺激素中区片段(44 - 68)的检测结果进行了比较。两种检测方法在正常对照组与原发性或继发性甲状旁腺功能亢进患者之间均有良好的区分能力。在慢性肾衰竭患者中,完整甲状旁腺激素检测对于显示甲状旁腺分泌情况最为适用。这种新方法的一个重要优势在于能够诊断甲状旁腺功能减退症中的甲状旁腺激素分泌不足以及肿瘤性高钙血症,而这是中区甲状旁腺激素测定无法做到的。静脉注射钙剂(5分钟内注射2mg/kg)和合成甲状旁腺激素片段(2分钟内注射6U/kg 1 - 38 hPTH)后,5分钟时血清完整甲状旁腺激素降低至初始值的一半左右。因此,检测完整甲状旁腺激素是一种适用于确定疾病状态下以及功能测试过程中甲状旁腺分泌增加和减少情况的方法。该方法操作简单,仅受轻微干扰,因此也适合作为常规实验室检测方法。