射频消融治疗继发性甲状旁腺功能亢进的疗效与安全性：一项系统评价和荟萃分析

Efficacy and safety of radiofrequency ablation for secondary hyperparathyroidism: a systematic review and meta-analysis.

作者信息

Li Mengyuan, Jiang Hongwei, Wang Yunchang, Li Fujun

机构信息

Department of Ultrasound, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan Province, 471003, China.

Department of Endocrinology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan Province, 471003, China.

出版信息

Asian Biomed (Res Rev News). 2024 Dec 16;18(6):287-296. doi: 10.2478/abm-2024-0036. eCollection 2024 Dec.

DOI:10.2478/abm-2024-0036

PMID:39697216

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11650422/

Abstract

BACKGROUND

Secondary hyperparathyroidism (SHPT) is a common complication of chronic kidney disease (CKD) that affects approximately 90% of end-stage renal disease and poses a significant threat to long-term survival and quality of life in patients.

OBJECTIVES

To assess whether radiofrequency ablation (RFA) is a productive and low-risk treatment for hyperparathyroidism secondary to CKD.

METHODS

Embase, Web of Science, Cochrane Library, and PubMed were searched independently by two authors. The results after RFA and baseline biochemical indicators were compared, and parathyroid hormone (PTH), serum calcium, and serum phosphorus levels were the major outcomes.

RESULTS

Four retrospective studies were screened out from 147 original literature and involved 118 cases. After RFA, serum PTH levels (1 d standardized mean difference [SMD] = -2.30, 95% confidence interval [CI] = from -3.04 to -1.56, < 0.0001; 6 months SMD = -2.15, 95% CI = from -3.04 to -1.26, < 0.0001; 12 months SMD = -2.35, 95% CI = from -3.52 to -1.17, < 0.0001), serum calcium levels (1 d SMD = -1.49, 95% CI = from -2.18 to -0.81, = 0.0001; 6 months SMD = -1.09, 95% CI = from -1.51 to -0.68, < 0.0001), and serum phosphorus levels (1 d SMD = -1.37, 95% CI = from -1.67 to -1.07, < 0.0001; 6 months SMD = -1.06, 95% CI = from -1.35 to -0.78, < 0.0001) decreased significantly.

CONCLUSIONS

RFA, the newest thermal ablation technique, can effectively and safely treat hyperparathyroidism secondary to CKD. Hoarseness is the most common complication but is reversed within 6 months.

摘要

背景

继发性甲状旁腺功能亢进（SHPT）是慢性肾脏病（CKD）的常见并发症，影响约90%的终末期肾病患者，对患者的长期生存和生活质量构成重大威胁。

目的

评估射频消融（RFA）是否是一种有效且低风险的治疗CKD继发性甲状旁腺功能亢进的方法。

方法

两名作者独立检索了Embase、Web of Science、Cochrane图书馆和PubMed。比较了RFA后的结果和基线生化指标，主要观察指标为甲状旁腺激素（PTH）、血清钙和血清磷水平。

结果

从147篇原始文献中筛选出4项回顾性研究，涉及118例患者。RFA后，血清PTH水平（1天标准化均数差[SMD]=-2.30，95%置信区间[CI]=-3.04至-1.56，P<0.0001；6个月SMD=-2.15，95%CI=-3.04至-1.26，P<0.0001；12个月SMD=-2.35，95%CI=-3.52至-1.17，P<0.0001）、血清钙水平（1天SMD=-1.49，95%CI=-2.18至-0.81，P=0.0001；6个月SMD=-1.09，95%CI=-1.51至-0.68，P<0.0001）和血清磷水平（1天SMD=-1.37，95%CI=-1.67至-1.07，P<0.0001；6个月SMD=-1.06，95%CI=-1.35至-0.78，P<0.0001）均显著下降。