Department of Ultrasound Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China.
Department of Pathology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China.
Medicine (Baltimore). 2023 Dec 15;102(50):e36514. doi: 10.1097/MD.0000000000036514.
To retrospectively analyze the diagnosis and treatment of secondary hyperparathyroidism (SHPT) combined with thyroid disease, and to investigate the correlation between SHPT and papillary thyroid carcinoma (PTC), SHPT and thyroid disease, and the importance of preoperative localization diagnosis in patients with SHPT. Clinical data of 101 patients who underwent surgical treatment for SHPT at the Third Hospital of Hebei Medical University were collected from August 2014 to May 2023, and patients were divided into SHPT without PTC group (n = 94) and SHPT with PTC group (n = 7) according to their postoperative pathology. Patients were divided into SHPT without thyroid disease group (n = 32) and SHPT with thyroid disease group (n = 69) according to their preoperative ultrasound diagnosis and postoperative pathology. The differences between the 2 groups were compared to explore the association between SHPT and PTC and between SHPT and thyroid disease. Of the 101 patients with SHPT, 65 were male and 36 were female with a mean age of (44.26 ± 11.16) years. There were 69 patients (68.32%) with concomitant thyroid disease and 32 patients (31.68%) without concomitant thyroid disease, including 7 patients (6.93%) with PTC. The results of univariate analysis showed that the differences in age and preoperative PTH levels between the SHPT without PTC group and the SHPT with PTC group were statistically significant (P < 0. 05),There were no significant differences in age, gender, preoperative PTH, preoperative alkaline phosphatase, preoperative serum calcium, preoperative serum phosphorus, preoperative serum creatinine, duration of dialysis disease, and whether they were accompanied by hypertension or not between the SHPT without thyroid disease group and the SHPT with thyroid disease group (P > 0. 05), logistic regression analysis showed that there was a correlation between the age of patients with SHPT and the level of preoperative PTH with PTC. In patients with SHPT, concomitant thyroid disease is more common, so patients with SHPT should be screened for thyroid disease at the same time as routine preoperative ultrasonography combined with nuclear scan for localized diagnosis, and surgical resection is preferred if concomitant PTC is present.
回顾性分析继发性甲状旁腺功能亢进症（SHPT）合并甲状腺疾病的诊断和治疗，并探讨 SHPT 与甲状腺乳头状癌（PTC）、SHPT 与甲状腺疾病的相关性，以及术前定位诊断对 SHPT 患者的重要性。收集 2014 年 8 月至 2023 年 5 月在河北医科大学第三医院接受手术治疗的 101 例 SHPT 患者的临床资料，根据术后病理将患者分为 SHPT 无 PTC 组（n=94）和 SHPT 有 PTC 组（n=7）。根据术前超声诊断和术后病理将患者分为 SHPT 无甲状腺疾病组（n=32）和 SHPT 有甲状腺疾病组（n=69）。比较两组间差异，探讨 SHPT 与 PTC 及 SHPT 与甲状腺疾病的相关性。101 例 SHPT 患者中，男 65 例，女 36 例，年龄（44.26±11.16）岁。合并甲状腺疾病 69 例（68.32%），无甲状腺疾病 32 例（31.68%），其中 PTC 7 例（6.93%）。单因素分析结果显示，SHPT 无 PTC 组与 SHPT 有 PTC 组患者的年龄、术前甲状旁腺激素水平差异有统计学意义（P<0.05）；SHPT 无甲状腺疾病组与 SHPT 有甲状腺疾病组患者的年龄、性别、术前甲状旁腺激素、碱性磷酸酶、血清钙、血清磷、血清肌酐、透析病程、是否合并高血压比较差异无统计学意义（P>0.05）。Logistic 回归分析显示，SHPT 患者年龄与术前甲状旁腺激素水平与 PTC 相关。SHPT 患者中合并甲状腺疾病更为常见，因此，在常规术前超声检查结合核素扫描进行定位诊断的同时，应筛查 SHPT 患者的甲状腺疾病，如果存在合并 PTC，应首选手术切除。
