Imrie C W, Beastall G H, Allam B F, O'Neil J, Benjamin I S, McKay A J
Br J Surg. 1978 Oct;65(10):717-20. doi: 10.1002/bjs.1800651013.
Sequential daily measurements of plasma parathyroid hormone (PTH) have been performed in 89 patients with acute pancreatitis. A total of 439 PTH assays was obtained during 98 episodes of the disease. Three main patterns of PTH response were found. These responses were correlated with severity of disease graded by objective criteria and also to corrected serum calcium levels. The first type of PTH response was characterized by significantly elevated PTH levels soon after hospitalization with a subsequent decrease in levels to within the normal range by the third or fourth day of illness. This type of response was specifically associated with transient severe hypocalcaemia (corrected calcium less than 2.0 mmol/l). It was also associated with the most severe forms of disease and 6 of the 7 deaths. The second type of PTH response revealed initial PTH values in the upper level of the normal range (400--600 ng/l) while persistently low PTH levels were characteristic of the third type of response. Persistently low PTH levels were associated with normocalcaemia, and no patient in this group died. None of a group of 14 control patients exhibited the type 1 PTH response. An effective PTH response to an unidentified hypocalcaemic stimulus results in satisfactory calcium homeostasis in most patients with acute pancreatitis.
对89例急性胰腺炎患者进行了血浆甲状旁腺激素（PTH）的连续每日测定。在98次发病期间共获得439次PTH检测结果。发现了三种主要的PTH反应模式。这些反应与根据客观标准分级的疾病严重程度以及校正后的血清钙水平相关。第一种PTH反应类型的特征是住院后不久PTH水平显著升高，随后在发病第三天或第四天降至正常范围内。这种反应类型与短暂性严重低钙血症（校正钙低于2.0 mmol/L）特别相关。它也与最严重的疾病形式以及7例死亡中的6例相关。第二种PTH反应类型显示初始PTH值在正常范围上限（400 - 600 ng/L），而持续低PTH水平是第三种反应类型的特征。持续低PTH水平与血钙正常相关，该组中无患者死亡。14名对照患者中无一表现出1型PTH反应。对未明低钙血症刺激的有效PTH反应可使大多数急性胰腺炎患者的钙稳态良好。
