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[原发性甲状旁腺功能亢进症临床实践指南,简版]

[The clinical practice guidelines for primary hyperparathyroidism, short version].

作者信息

Mokrysheva N G, Eremkina A K, Mirnaya S S, Krupinova J A, Voronkova I A, Kim I V, Beltsevich D G, Kuznetzov N S, Pigarova E A, Rozhinskaya L Ya, Degtyarev M V, Egshatyan L V, Rumiantsev P A, Andreeva E N, Аntsiferov M B, Markina N V, Kryukova I V, Karonova T L, Lukyanov S V, Sleptcov I V, Chagai N B, Melnichenko G A, Dedov I I

机构信息

Endocrinology Resarch Centre.

Endocrinology Research Centre.

出版信息

Probl Endokrinol (Mosk). 2021 Aug 19;67(4):94-124. doi: 10.14341/probl12801.

Abstract

Primary hyperparathyroidism (PHPT) is an endocrine disorder of parathyroid glands characterized by excessive secretion of parathyroid hormone (PTH) with an upper normal or elevated blood calcium level. Classical PHPT refers to a symptomatic, multi-system disorder, wich can lead to a significant decrease in the quality of life, disability of patients, and even an increased risk of premature death. Hypercalcemia and the catabolic effect of PTH on various cells are considered as the main pathogenetic mechanisms of the PHPT associated complications. In the last two decades, there has been an increase in the incidence of PHPT, mainly due to the mild forms of the disease, primarily due to the routine calcium screening in North America, Western Europe and, Asia. High prevalence of the disease, as well as the variety of clinical manifestations, cause the attention of different specialists - physicians, rheumatologists, urologists, nephrologists, cardiologists and other doctors. This review cover the main issues of Russian guidelines for the management of PHPT, approved in 2020, including laboratory and instrumental methods, differential diagnosis, surgical and conservative approach, short-term and long-term follow-up. This guidelines also include the recommendations for special groups of patients with hereditary forms of PHPT, parathyroid carcinoma, PHPT during pregnancy.

摘要

原发性甲状旁腺功能亢进症(PHPT)是一种甲状旁腺的内分泌紊乱疾病,其特征是甲状旁腺激素(PTH)分泌过多,同时血钙水平处于正常上限或升高。典型的PHPT是一种有症状的多系统疾病,可导致生活质量显著下降、患者残疾,甚至增加过早死亡的风险。高钙血症以及PTH对各种细胞的分解代谢作用被认为是PHPT相关并发症的主要发病机制。在过去二十年中,PHPT的发病率有所上升,主要归因于该病的轻症形式,这主要是由于北美、西欧和亚洲开展了常规血钙筛查。该病的高患病率以及各种临床表现引起了不同专科医生(内科医生、风湿病学家、泌尿科医生、肾病学家、心脏病学家等)的关注。本综述涵盖了2020年批准的俄罗斯PHPT管理指南的主要问题,包括实验室和仪器检查方法、鉴别诊断、手术和保守治疗方法、短期和长期随访。本指南还包括针对患有遗传性PHPT、甲状旁腺癌、妊娠期PHPT等特殊患者群体的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15fb/9753843/06a598ad5cb6/problendo-67-12801-g001.jpg

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