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甲状腺切除术后降钙素会导致低钙血症吗?

Does calcitonin cause hypocalcaemia after thyroidectomy?

作者信息

Sawers J S, Kellett H A, Brown N S, Beckett G J, Seth J, Sinclair I S, Toft A D

出版信息

Br J Surg. 1982 Aug;69(8):456-8. doi: 10.1002/bjs.1800690807.

Abstract

Plasma calcitonin, parathyroid hormone, total thyroid hormones and calcium were measured in 6 patients before, during and after thyroidectomy for hyperthyroidism. In 4 patients, plasma calcium fell postoperatively by 0.23--0.46 mmol/l, but there was no change in calcitonin or parathyroid hormone levels. In one patient, in whom there was a postoperative fall in plasma calcium of 0.55 mmol/l, thyroid hormones rose to a peak at 1 h and calcitonin to a peak at 12 h after resection. However, the rise in calcitonin occurred 8 h after the initial decrease in plasma calcium. In this patient, parathyroid hormone levels showed a slight rise only. It is concluded that, while thyroid hormones and calcitonin may leak from the damaged thyroid remnant after surgery, it is unlikely that calcitonin is important in the production of postoperative hypocalcaemia. However, impaired parathyroid hormone secretion may be a contributing factor.

摘要

对6例因甲亢行甲状腺切除术的患者,在术前、术中及术后测定了血浆降钙素、甲状旁腺激素、总甲状腺激素和钙水平。4例患者术后血浆钙下降了0.23 - 0.46 mmol/l,但降钙素或甲状旁腺激素水平无变化。1例患者术后血浆钙下降了0.55 mmol/l,甲状腺激素在切除后1小时升至峰值,降钙素在切除后12小时升至峰值。然而,降钙素的升高发生在血浆钙最初下降8小时后。该患者甲状旁腺激素水平仅略有升高。结论是,虽然甲状腺激素和降钙素可能在手术后从受损的甲状腺残余组织中漏出,但降钙素不太可能在术后低钙血症的发生中起重要作用。然而,甲状旁腺激素分泌受损可能是一个促成因素。

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