Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
J Ultrasound Med. 2021 Nov;40(11):2497-2505. doi: 10.1002/jum.15638. Epub 2021 Jan 23.
A previous 12-month study confirmed that microwave ablation (MWA) was effective for moderate secondary hyperparathyroidism (SHPT). A further analysis was performed in this study to evaluate the efficacy of MWA for moderate SHPT over an observational follow-up period of up to 60 months.
This was a retrospective cohort study of patients involved in a previous randomized controlled trial. Patients were divided into an MWA group (those who underwent MWA followed by drug therapy according to the patient's clinical situation) and a control group (those who received drug therapy only). The primary outcome was the composite endpoint. During the efficacy assessment phase, the two groups were compared in terms of the proportion of patients with intact parathyroid hormone (iPTH) levels <300 pg/ml and the differences in iPTH levels.
Twenty-seven patients were included in this study: 13 in the MWA group and 14 in the control group. The median (interquartile range) follow-up periods of the MWA and control groups were 58 (54-60) and 58 (49-60) months, respectively. The proportion of patients with iPTH levels <300 pg/ml in the MWA group was slightly higher than that in the control group (6/13 [46.2%] versus 2/14 [14.3%], respectively; p = .08). Furthermore, iPTH levels in the MWA group were lower than in the control group during the efficacy assessment phase (411 ± 299 pg/ml versus 516 ± 369 pg/ml, respectively; p <.01).
MWA helped to contain the necessary iPTH levels in patients undergoing hemodialysis for moderate SHPT in a 60-month timeframe.
先前的一项 12 个月研究证实微波消融（MWA）对中度继发性甲状旁腺功能亢进症（SHPT）有效。本研究进一步分析了在观察随访期长达 60 个月的情况下，MWA 治疗中度 SHPT 的疗效。
这是一项回顾性队列研究，涉及先前的一项随机对照试验中的患者。患者分为 MWA 组（根据患者的临床情况接受 MWA 后药物治疗）和对照组（仅接受药物治疗）。主要结局为复合终点。在疗效评估阶段，比较两组患者甲状旁腺激素（iPTH）水平<300 pg/ml 的比例和 iPTH 水平的差异。
本研究纳入 27 例患者：MWA 组 13 例，对照组 14 例。MWA 组和对照组的中位（四分位距）随访时间分别为 58（54-60）和 58（49-60）个月。MWA 组 iPTH 水平<300 pg/ml 的患者比例略高于对照组（6/13 [46.2%]与 2/14 [14.3%]，p=0.08）。此外，在疗效评估阶段，MWA 组的 iPTH 水平低于对照组（411±299 pg/ml 与 516±369 pg/ml，p<0.01）。
在 60 个月的时间内，MWA 有助于控制接受血液透析的中度 SHPT 患者的必要 iPTH 水平。
