Suzuki S, Watanabe I, Endou S
Nihon Geka Gakkai Zasshi. 1983 Oct;84(10):1025-30.
In order to elucidate the function of parathyroid autograft, we determined the plasma parathyroid hormone (PTH) levels in the blood from cubital veins in two patients who had parathyroid autotransplantation after total parathyroidectomy. The first patient with chronic renal failure had been treated by hemodialysis for the past nine years and showed marked symptoms due to secondary hyperparathyroidism for five years. The second patient showed an evidence of recurrence of parathyroid cancer three years after the initial operation carried out elsewhere. The parathyroid tissue of 80 mg was sliced into 25 pieces and transplanted into separate pockets in one of the brachioradial muscles of the forearm. These patients showed an increase in plasma PTH levels two weeks after surgery. Plasma calcium level returned to the normal range three months after operation. Artificial hypocalcemia was induced by an injection of porcine calcitonin at ten months after surgery and a reserve of PTH secretion was tested. An increase of plasma C-PTH and N-PTH levels were recognized in the two patients as well as in the normal healthy volunteers. It was shown that parathyroid autograft has sufficient function to maintain normocalcemia and a reserve of function to respond against an artificially induced hypocalcemia at the tenth month after autografting.
为了阐明甲状旁腺自体移植的功能,我们测定了两名在甲状旁腺全切除术后进行甲状旁腺自体移植患者的肘静脉血中血浆甲状旁腺激素(PTH)水平。首例慢性肾衰竭患者过去九年一直接受血液透析治疗,因继发性甲状旁腺功能亢进出现明显症状已有五年。第二例患者在其他地方初次手术后三年出现甲状旁腺癌复发迹象。将80mg甲状旁腺组织切成25片,移植到前臂桡侧腕屈肌的不同部位。这些患者术后两周血浆PTH水平升高。术后三个月血浆钙水平恢复到正常范围。术后十个月通过注射猪降钙素诱发人工低钙血症,并检测PTH分泌储备功能。两名患者以及正常健康志愿者的血浆C-PTH和N-PTH水平均升高。结果表明,甲状旁腺自体移植具有足够的功能来维持血钙正常,并且在自体移植后第十个月具有应对人工诱发低钙血症的功能储备。