Gao Jinwei, Zhang Qi, Wang Zesheng, Guo Yibin, Liang Shengchang, Zhang Yupeng, Qu Kunpeng
Department of General Surgery，Gansu Provincial People's Hospital，Lanzhou，730000，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 May;37(5):365-369. doi: 10.13201/j.issn.2096-7993.2023.05.009.
To investigate the relationship between parathyroid hormone（PTH） level and permanent hypoparathyroidism（PHPP） on the first day after radical papillary thyroidectomy, and its predictive value. A total of 80 patients with papillary thyroid cancer who underwent total thyroid resection and central lymph node dissection were collected and analyzed from January 2021 to January 2022. According to whether PHPP occurred after surgery, the patients were divided into hypoparathyroidism group and normal parathyroid function group, and univariate and binary logistics regression were used to analyze the correlation between PTH and serum calcium levels and PHPP on the first day after surgery in two groups. The dynamic changes of PTH at different time points after operation were analyzed. The area under the receiver operating characteristic was used to evaluate the predictive power of PTH on the development of PHPP after surgery. Among the 80 patients with papillary thyroid cancer, 10 cases developed PHPP, with an incidence rate of 12.5%. Binary logistics regression analysis showed that PTH on the first postoperative day（=14.534, 95%: 2.377-88.858, =0.004） was an independent predictive risk factor for postoperative PHPP. Taking PTH=8.75 ng/L on the first postoperative day as the cut-off value, the AUC of the area under the curve was 0.874（95%: 0.790-0.958, <0.001）, the sensitivity was 71.4%, the specificity was 100%, and the Yoden index was 0.714. PTH level on the first day after total thyroid papillary carcinoma surgery is closely related to PHPP, and is an independent predictor of PHPP.
探讨甲状腺乳头状癌根治术后第1天甲状旁腺激素（PTH）水平与永久性甲状旁腺功能减退症（PHPP）的关系及其预测价值。收集2021年1月至2022年1月期间80例行甲状腺全切除术及中央区淋巴结清扫术的甲状腺乳头状癌患者进行分析。根据术后是否发生PHPP，将患者分为甲状旁腺功能减退组和甲状旁腺功能正常组，采用单因素和二元逻辑回归分析两组患者术后第1天PTH与血钙水平及PHPP的相关性。分析术后不同时间点PTH的动态变化。采用受试者工作特征曲线下面积评估PTH对术后PHPP发生的预测能力。80例甲状腺乳头状癌患者中，10例发生PHPP，发生率为12.5%。二元逻辑回归分析显示，术后第1天的PTH（=14.534，95%：2.377 - 88.858，=0.004）是术后PHPP的独立预测危险因素。以术后第1天PTH = 8.75 ng/L为截断值，曲线下面积AUC为0.874（95%：0.790 - 0.958，<0.001），灵敏度为71.4%，特异度为100%，约登指数为0.714。甲状腺乳头状癌全切除术后第1天的PTH水平与PHPP密切相关，是PHPP的独立预测指标。
