Van'T Hoff W, Ballardie F W, Bicknell E J
Br Med J (Clin Res Ed). 1983 Nov 26;287(6405):1605-8. doi: 10.1136/bmj.287.6405.1605.
Thirty two patients with primary hyperparathyroidism were followed up medically for a mean of 4.2 years. One patient had an operation because of a rise in plasma calcium concentration. There was no significant change in the mean plasma calcium and creatinine concentrations or in blood pressure during the period of follow up. The progress of these patients who were managed medically was compared with that of a group of 60 patients who had had successful operations for primary hyperparathyroidism. There was no significant change in mean plasma creatinine concentration or in blood pressure in the group who had had operations during a mean follow up period of 5.9 years. The natural history of mild asymptomatic hyperparathyroidism is probably different from and better than that of the type of hyperparathyroidism that was usually seen before the advent of routine chemical screening. It is suggested that patients over the age of 60 with mild asymptomatic hyperparathyroidism, and perhaps even younger patients, may not require operation.
32例原发性甲状旁腺功能亢进患者接受了平均4.2年的医学随访。1例患者因血浆钙浓度升高接受了手术。随访期间，平均血浆钙和肌酐浓度以及血压均无显著变化。将这些接受药物治疗的患者的病情进展与一组60例成功接受原发性甲状旁腺功能亢进手术的患者进行了比较。在平均5.9年的随访期内，接受手术的患者组的平均血浆肌酐浓度和血压均无显著变化。轻度无症状甲状旁腺功能亢进的自然病程可能与常规化学筛查出现之前常见的甲状旁腺功能亢进类型不同，且更好。建议60岁以上的轻度无症状甲状旁腺功能亢进患者，甚至可能更年轻的患者，可能不需要手术。
