Carmignani G, Belgrano E, Puppo P, Repetto U, Giusti M, Giordano G, Giuliani L
Eur Urol. 1982;8(2):102-6. doi: 10.1159/000473489.
PTH radioimmunoassay today represents an unreplaceable tool in the diagnosis of primary hyperparathyroidism. However, the diagnostic importance of its dosage on selective venous samples is still discussed. Herein, we report our experience of 47 patients operated on for primary hyperparathyroidism. The catheterization of neck veins was performed according to Doppman and co-workers. The PTH assay was carried out with COOH- and NH2-specific antisera. (In 5 cases an inhibition test with CaCl2 infusion was practiced during selective catheterization to preoperatively discriminate between adenoma and hyperplasia.) In 8 cases loading tests with EDTA and in 6 cases with CaCl2 were also performed in association with peripheral venous sampling, in an attempt to improve its sensibility. The 47 cases operated upon showed the following results: the peripheral PTH values were significantly raised in 60% of the cases; the selective PTH dosage with COOH-specific antiserum showed a parathyroid hyperfunction in 100% of the surgically confirmed cases, whereas with the NH2-specific antiserum an increased PTH rate was found only in 84%. A right preoperative localization was obtained in 73%. The value of loading tests is more difficult to evaluate and is discussed in detail.
如今，甲状旁腺激素放射免疫测定法是诊断原发性甲状旁腺功能亢进症不可替代的工具。然而，其在选择性静脉样本检测中的诊断重要性仍存在争议。在此，我们报告对47例原发性甲状旁腺功能亢进症患者进行手术的经验。颈静脉插管按照多普曼及其同事的方法进行。使用针对羧基和氨基的特异性抗血清进行甲状旁腺激素检测。（5例患者在选择性插管期间进行了氯化钙输注抑制试验，以术前区分腺瘤和增生。）8例患者进行了乙二胺四乙酸负荷试验，6例患者进行了氯化钙负荷试验，并与外周静脉采样相结合，以提高其敏感性。47例接受手术的患者结果如下：60%的病例外周甲状旁腺激素值显著升高；使用针对羧基的特异性抗血清进行选择性甲状旁腺激素检测显示，100%经手术证实的病例存在甲状旁腺功能亢进，而使用针对氨基的特异性抗血清时，仅84%的病例甲状旁腺激素水平升高。术前正确定位率为73%。负荷试验的价值更难评估，将详细讨论。
